TY - JOUR
T1 - Bone density, microarchitecture and tissue quality after 1 year of treatment with dolutegravir/abacavir/lamivudine
AU - Soldado-Folgado, Jade
AU - Lerma-Chippirraz, Elisabeth
AU - Arrieta-Aldea, Itziar
AU - Bujosa, Daniel
AU - García-Giralt, Natalia
AU - Pineda-Moncusi, Marta
AU - Trenchs-Rodríguez, Marta
AU - Villar-García, Judit
AU - González-Mena, Alicia
AU - Díez-Pérez, Adolfo
AU - Brown, Todd T.
AU - Knobel, Hernando
AU - Güerri-Fernández, Robert
N1 - Publisher Copyright:
© 2020 Oxford University Press. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Background: Bone mineral density (BMD) decreases with ART initiation with a tenofovir disoproxil fumaratecontaining regimen, although bone tissue quality increases. The impact of dolutegravir (DTG)/abacavir (ABC)/ lamivudine (3TC)-based ART initiation on bone health parameters is not clear. Objectives: To study the impact of DTG/ABC/3TC-based therapy on bone health parameters in ART-naive individuals with HIV after 48 weeks of treatment. Methods: An observational, prospective and analytical study of treatment-naive patients with HIV undergoing a DTG/ABC/3TC-based regimen at 48 week follow-up. Changes in bone strength parameters (BMD, bone microarchitecture and bone tissue quality) were assessed with non-parametric methods. Results: Sixteen HIV-infected ART-naive patients starting DTG/ABC/3TC were included. BMD in the lumbar spine showed a significant decrease of#2.25% (P = 0.007) and#4.1% in the femoral neck (P = 0.007). Bone microarchitecture, as measured by trabecular bone score, also decreased significantly by #2.5% (P = 0.03). In contrast, bone quality [bone material strength index (BMi)], as measured by microindentation, significantly increased with respect to baseline after 48 weeks of treatment, showing better bone properties of !6.53% (P < 0.001). No significant changes were found in bone turnover markers. In addition, a positive significant correlation between the CD4/CD8 cell count ratio at baseline and changes in BMSi after 48 weeks of treatment was observed (Spearman's rho = 0.4974; P = 0.04). Conclusions: After a 48 week treatment with DTG/ABC/3TC-based ART, BMD and trabecular bone score decreased while bone tissue quality, as measured by microindentation, improved significantly. The state of the immune systemat ART initiation is related to bone quality recovery. An overarching approach to assess bone toxicity in ART-Treated patients is needed.
AB - Background: Bone mineral density (BMD) decreases with ART initiation with a tenofovir disoproxil fumaratecontaining regimen, although bone tissue quality increases. The impact of dolutegravir (DTG)/abacavir (ABC)/ lamivudine (3TC)-based ART initiation on bone health parameters is not clear. Objectives: To study the impact of DTG/ABC/3TC-based therapy on bone health parameters in ART-naive individuals with HIV after 48 weeks of treatment. Methods: An observational, prospective and analytical study of treatment-naive patients with HIV undergoing a DTG/ABC/3TC-based regimen at 48 week follow-up. Changes in bone strength parameters (BMD, bone microarchitecture and bone tissue quality) were assessed with non-parametric methods. Results: Sixteen HIV-infected ART-naive patients starting DTG/ABC/3TC were included. BMD in the lumbar spine showed a significant decrease of#2.25% (P = 0.007) and#4.1% in the femoral neck (P = 0.007). Bone microarchitecture, as measured by trabecular bone score, also decreased significantly by #2.5% (P = 0.03). In contrast, bone quality [bone material strength index (BMi)], as measured by microindentation, significantly increased with respect to baseline after 48 weeks of treatment, showing better bone properties of !6.53% (P < 0.001). No significant changes were found in bone turnover markers. In addition, a positive significant correlation between the CD4/CD8 cell count ratio at baseline and changes in BMSi after 48 weeks of treatment was observed (Spearman's rho = 0.4974; P = 0.04). Conclusions: After a 48 week treatment with DTG/ABC/3TC-based ART, BMD and trabecular bone score decreased while bone tissue quality, as measured by microindentation, improved significantly. The state of the immune systemat ART initiation is related to bone quality recovery. An overarching approach to assess bone toxicity in ART-Treated patients is needed.
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U2 - 10.1093/jac/dkaa254
DO - 10.1093/jac/dkaa254
M3 - Article
C2 - 32710105
AN - SCOPUS:85091324980
SN - 0305-7453
VL - 75
SP - 2998
EP - 3003
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 10
ER -