Changes in Bone Mineral Density After Initiation of Antiretroviral Treatment With Tenofovir Disoproxil Fumarate/Emtricitabine Plus Atazanavir/Ritonavir, Darunavir/Ritonavir, or Raltegravir
Changes in Bone Mineral Density After Initiation of Antiretroviral Treatment With Tenofovir Disoproxil Fumarate/Emtricitabine Plus Atazanavir/Ritonavir, Darunavir/Ritonavir, or Raltegravir
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DOI：
10.1093/infdis/jiv194
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发表时间：
2015-10-15
影响因子：
6.4
通讯作者：
McComsey, Grace A.
中科院分区：
文献类型：
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作者：
Brown, Todd T.;Moser, Carlee;McComsey, Grace A.
背景资料。特定的抗逆转录病毒治疗(ART)药物和治疗前人类免疫缺陷病毒(HIV)疾病的严重程度导致ART治疗后骨密度(BMD)的丢失。我们比较了328名HIV感染者的骨密度在96周内的变化百分比，这些人被随机分为替诺福韦富马酸二异丙酯/恩曲他滨(TDF/FTC)+阿扎那韦/利托那韦(ATV/r)、达鲁那韦/利托那韦(DRV/r)或雷替格列韦(Raltegravir)。我们还确定了炎症标记物的基线水平和免疫激活是否与骨密度丢失独立相关。在96周时，蛋白水解酶抑制剂(PI)组脊柱和髋部BMD较基线的平均百分比变化相似(脊柱：ATV/r组-4.0%vs DRV/r组-3.6%[P=.42]；髋部：-3.9%vs DRV/r组-3.4%[P=.36])，但联合PI组大于前臂(脊柱：-3.8%vs-1.8%[P=.
Background. Specific antiretroviral therapy (ART) medications and the severity of human immunodeficiency virus (HIV) disease before treatment contribute to bone mineral density (BMD) loss after ART initiation.Methods. We compared the percentage change in BMD over 96 weeks in 328 HIV-infected, treatment-naive individuals randomized equally to tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) plus atazanavir/ritonavir (ATV/r), darunavir/ritonavir (DRV/r), or raltegravir (RAL). We also determined whether baseline levels of inflammation markers and immune activation were independently associated with BMD loss.Results. At week 96, the mean percentage changes from baseline in spine and hip BMDs were similar in the protease inhibitor (PI) arms (spine: -4.0% in the ATV/r group vs -3.6% in the DRV/r [P=.42]; hip: -3.9% in the ATV/r group vs -3.4% in the DRV/r group [P=.36]) but were greater in the combined PI arms than in the RAL arm (spine: -3.8% vs -1.8% [P