Abstract: FR-PO0272
Dual Burden of HIV Infection and Aging on Kidney Function and Skeletal Health
Session Information
- Bone and Mineral Metabolism: Clinical Epidemiology and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Vaz, Julia Braga, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Da Eira, Margareth, Instituto de Infectologia Emilio Ribas, Sao Paulo, SP, Brazil
- Nickolas, Thomas L., Washington University in St Louis, Saint Louis, Missouri, United States
- Yin, Michael T., Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States
- Moyses, Rosa M.A., Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Araujo, Maria Julia C. L. N., Instituto de Infectologia Emilio Ribas, Sao Paulo, SP, Brazil
Background
With the advent of antiretroviral therapy (ART), HIV infection has transitioned into a manageable chronic condition, leading to increased life expectancy among people living with HIV (PLWH). As this population ages, the prevalence of age-related comorbidities, including CKD and osteoporosis, is rising. Despite this shift, awareness and recognition of these complications in older adults with HIV remain insufficient among healthcare professionals, potentially leading to underdiagnosis and suboptimal management.
Methods
We conducted a retrospective review of medical records for HIV-positive patients aged over 50 years who were receiving regular ART at a referral hospital. Exclusion criteria included immobilization, ART duration of less than 2 months, liver failure, pregnancy, diabetes mellitus, undernutrition, and a viral load > 500,000 copies/mL. Clinical data collected included duration since HIV diagnosis and use of tenofovir disoproxil fumarate (TDF). CKD was defined as an eGFR < 60 mL/min/1.73 m2 or the presence of albuminuria.
Results
Of 2,200 patients, 870 met inclusion criteria (63% male; median age 60 ys; 15% >70). Median HIV duration was 25 years; 75% had undetectable viral load and 85% had TDF exposure. Serum creatinine was measured in 96%, but microalbuminuria in only 55%. Low eGFR was found in 15.4%, and 25.8% had microalbuminuria (A2: 22.3%, A3: 3.5%). Vitamin D was assessed in 85%, but phosphate, calcium, and parahormone in only 58, 45, and 26%, respectively. Hypovitaminosis D was found in 53%, hyperparathyroidism in 39%, and hypophosphatemia in 3%. DXA was performed in only 46% of them, with 59% of osteopenia and 23% of osteoporosis. Hyperparathyroidism was present in 40% of patients with low BMD.
Conclusion
Older PLWH exhibit a high prevalence of CKD and CKD-associated osteoporosis, placing them at elevated risk for fragility fractures. These findings highlight the critical need for more comprehensive and targeted screening strategies within this population to enhance early detection and optimize management of these comorbid conditions.
Funding
- Other NIH Support