Human Immunodeficiency Virus (HIV) and Menopause Are Independently Associated With Lower Bone Mineral Density: Results From the Women's Interagency HIV Study

Authors

Anjali Sharma, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Donald R. Hoover, Department of Statistics, Institute for Health, Health Care Policy and Aging Research, Rutgers University, Piscataway, New Jersey, USA.
Qiuhu Shi, School of Health Sciences and Practice, New York Medical College, Valhalla, New York, USA.
Phyllis C. Tien, Department of Medicine, San Francisco VA Medical Center, San Francisco, California, USA.
Kathleen M. Weber, Cook County Health/Hektoen Institute of Medicine, Chicago, Illinois, USAand.
Jayesh G. Shah, Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA.
Michael T. Yin, Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA.

Author Type(s)

Faculty

DOI

10.1093/cid/ciab874

Journal Title

Clinical Infectious Diseases

First Page

65

Last Page

72

Document Type

Article

Publication Date

8-24-2022

Department

Public Health

Abstract

BACKGROUND: We previously reported lower bone mineral density (BMD) among premenopausal women with HIV (WWH) compared to women without HIV (HIV-). Rate of bone loss may be even greater for WWH during the menopausal transition. METHODS: Pre-, peri- and postmenopausal women in the Women\'s Interagency HIV Study (WIHS) underwent whole body DXA and central quantitative computed tomography to measure areal BMD (aBMD) and volumetric BMD (vBMD), respectively. Multivariable regression models with covariates associated with low aBMD (T score < -1.0) in univariate analyses (P≤.05) and known risk factors for low BMD assessed contributions of HIV and menopausal stage to the prediction of aBMD. RESULTS: Compared to HIV- women, in unadjusted analyses, WWH had 5-9% lower aBMD at the lumbar spine (P=.001), femoral neck (P=.04), total hip (P=.003) and the ultradistal radius (P=.004), and higher osteoporosis prevalence (T score<-2.5) at the ultradistal radius only (13.5% vs 0%, P=.0003). WWH also had lower vBMD at the spine and hip. In fully adjusted models, HIV independently predicted reduced aBMD at the lumbar spine, total hip, femoral neck, and ultradistal radius; menopausal stage remained a significant predictor of lumbar spine and ultradistal radius aBMD. CONCLUSIONS: HIV infection and menopausal stage were independent predictors of lower BMD, and had an additive effect on lumbar spine and total hip BMD. Additional research is needed to better understand underlying mechanisms by which HIV impacts BMD as women age and transition through menopause, and develop strategies to mitigate osteoporosis and fracture risk in this growing population.

Recommended Citation

Sharma, A., Hoover, D. R., Shi, Q., Tien, P. C., Weber, K. M., Shah, J. G., & Yin, M. T. (2022). Human Immunodeficiency Virus (HIV) and Menopause Are Independently Associated With Lower Bone Mineral Density: Results From the Women's Interagency HIV Study. Clinical Infectious Diseases, 75 (1), 65-72. https://doi.org/10.1093/cid/ciab874