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Association between Nonalcoholic Fatty Liver Disease and Bone Mineral Density in HIV-infected Patients Receiving Long-term TDF-based Antiretroviral Therapy

Author(s):

Zhijie Xu, Pengyuan He, Jianzhong Xian, Wuzhu Lu, Jingxian Shu, Wentao Luo, Chongjie Gan, Ruoman Ke, Jinyu Xia*, Zongping Han and Mingxing Huang*   Pages 1 - 7 ( 7 )

Abstract:


Background: Tenofovir (TDF) has a detrimental effect on bone mineral density (BMD), while nonalcoholic fatty liver disease (NAFLD) is associated with a lower BMD.

Objective: To help understand the mutual effects of NAFLD and TDF on BMD, this study was designed to explore the potential association between NAFLD and BMD in HIV-infected patients receiving long-term TDF-based antiretroviral therapy (ART).

Method: A total of 89 HIV-infected patients who received TDF-based ART for more than three years were enrolled in this cross-sectional study. We measured BMD using an ultrasonic bone density apparatus, and liver ultrasonography was performed to determine the severity of the fatty liver. The association of NAFLD with BMD was examined using multiple logistic regression analyses.

Results: Patients with NAFLD showed a worse BMD status than those without NAFLD. The incidences rates of osteopenia (42.86% versus 25.93%) and osteoporosis (17.14% versus 3.70%) were significantly higher in HIV-infected patients with NAFLD than in those without NAFLD. After multivariate adjustment, the odds ratio (OR) for patients with NAFLD exhibiting a worse BMD status compared with those without NAFLD was 4.49 (95% confidence interval [CI] 1.42, 14.15).

Conclusion: Based on our results, NAFLD was significantly associated with a worse BMD status, including osteopenia and osteoporosis, in HIV patients after receiving long-term TDF-based ART. Furthermore, we may want to avoid using TDF for ART in HIV-infected patients with NAFLD.

Keywords:

Bone mineral density, nonalcoholic fatty liver disease, tenofovir, HIV, bone toxicity, bone metabolism

Affiliation:

Department of Infectious Diseases, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Infectious Diseases, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Ultrasonography, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Ultrasonography, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Pharmacy, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Infectious Diseases, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Infectious Diseases, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Infectious Diseases, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Infectious Diseases, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Clinical Nutrition, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, Department of Infectious Diseases, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong



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