Abstract: FR-PO299

Bone Metabolism Markers, Epidemiological Profile, and Renal Function of HIV-Infected Patients before Initiating Antiretroviral Therapy

Session Information

Category: Mineral Disease

  • 1202 Mineral Disease: Vitamin D, PTH, FGF-23

Authors

  • Paula, Mariana G. Penido de, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Tupinambas, Unai, Federal University of MInas Gerais, Belo Horioznte, Brazil
  • Guimarães, Milena, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil
  • De, Nathalia Sernizon, Federal University of MInas Gerais, Belo Horioznte, Brazil
  • Penido, Maria Goretti M. G., Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Penido, Joao Milton, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
Background

Data suggests that the HIV population is prone to changes in bone metabolism and renal function. The aim of this study was to describe the bone metabolism markers, epidemiological profile, and renal function of HIV-infected patients before initiating antiretroviral therapy (ART).

Methods

Transversal study with naive patients on ART, aged from 18 to 55 years of age, that underwent clinical evaluation, bone densitometry by DXA (lumbar spine L1-L4) and laboratory measurement: calcium, phosphorus, PTH, 25(OH)vitD, FGF23 and interleukin 1β (IL-1β) and 6 (IL-6) serum levels. The following statistic tests were used: Mann Whitney, Kruskal-Wallis, and the Spearman correlation test. The CKD-EPI formula was used to evaluate the glomerular filtration rate.

Results

We evaluated 70 patients (57M) with median age of 33.8 years. 93% had more than eight years of schooling, 84% were working, 77% were single, and sexual transmission was 93%. The time to diagnosis ranged from 0.13 to 300 months. 51 patients underwent DXA and 9 had reduced bone mineral density (BMD) at lumbar spine, 3 at femoral neck and 5 at total femur. 58% of the patients had altered 25(OH)vitD: 21% had deficient serum levels and 37% had insufficient levels. There was no change in serum calcium, phosphorus, and PTH. The FGF23 correlated positively with calcium (r=0.358; p=0.004) and with IL-1β (r=0.308; p=0.013). There was a significant difference in the FGF23 in relation to PTH, being higher in those who had normal PTH levels (p=0.025) and its relation to the femoral neck Z score, being higher in those with index ≤-2 (p=0.039). 9.4% had CKD II.

Conclusion

The majority of the patients were young, professionally active, singles, and had HIV sexual transmission. Although they were young and naive patients, 9.4% had compromised renal function and 8.5% of them had reduced BMD. There was a high prevalence of vitamin D deficiency/insufficiency, most likely because of early onset. The relationship between FGF23, PTH, BMD Z-score and the correlation between FGF23 and calcium and IL-1β suggests that this phosphatonin could be considered an early marker of bone metabolism. More studies are needed to improve the follow up of bone metabolism and renal function, which are crucial and important in HIV patients.