Table 4.
Individual Study Findings of Postmenopausal Status and Low BMD or Fractures in HIV Infection
| Author | Outcome Variable | Findings (95% CI) | Significant Predictors in Multivariate Models |
|---|---|---|---|
| OR/PR of low BMD or osteoporosis | |||
| Anastos et al. (2007) | Low BMD (T-score <–1.0) and osteoporosis (T-score <–2.5) at LS or FN in HIV+ PoM versus HIV+ PrM | OR low BMD: 3.2 (1.6 to 6.2) OR osteoporosis: 4.8 (1.2 to 18.9) |
ART-naïve, HIV on ART with PI, postmenopause |
| Cazanave et al. (2008) | Low BMD (T-score < –1.0) at LS or FN in HIV+ PoM versus HIV+ PrM | OR low BMD: 1.2 (0.54 to 2.7)b OR osteoporosis: 7.1 (1.9 to 26.4)b |
Older age, nadir CD4 cell count |
| Gomes et al. (2014) d | Low BMD (T-score <–1.0) at LS and FN in HIV+ PoM versus HIV+ PrM or perimenopausal | PR low BMD LS: 23.3 (7.3 to 74.2) PR low BMD FN: 56.7 (7.9 to 409.4) |
Postmenopause |
| Pinto Neto et al. (2011) d | Odds of low BMD (T-score <–1.0) at LS, FN, or total hip in HIV+/PoM versus HIV+ men and women not PoM | OR: 13.4 (2.5 to 71.1) | Male, lower BMI, postmenopause, undetectable viral load |
| Yin et al. (2005) c | Osteoporosis (T-score < –2.5) at LS, FN, and non-dominant radius in HIV+ PoM versus HIV– PoM | OR osteoporosis: 2.4 (1.1 to 5.3)b | Years since menopause, lowest historical weight |
| Change in BMD | |||
| Jacobson et al. (2008) | Annual percent change in total body BMD in HIV+ PoM versus HIV+ PrM | PoM: –1.0 (–1.7 to –0.34)a PrM: 0.12 (–0.16 to 0.41)a |
Postmenopause, low albumin (mg/dL), lower BMI, no strength training, prednisone/hydrocortisone use, time on ART (d4T, ddi, tenofovir, saquinavir) |
| Li Vecchi et al. (2012) | Correlation between postmenopause and BMD T-score at LS and FN | Correlation coefficient LS = –0.17a Correlation coefficient FN =–0.17a |
HIV/HCV co-infection, older age, low yogurt intake, nadir CD4, drug addiction |
| Sharma et al. (2011) | Annual change in BMD (g/cm2) at LS, FN, and total hip associated with PoM in HIV+ | LS: –0.010 (–0.019 to –0.001) FN: –0.007 (–0.014 to 0.000) TH: –0.016 (–0.024 to –0.008) |
Postmenopause, methadone use, baseline BMD, lower BMI, no protease inhibitor use |
| HR of fractures | |||
| Yin et al. (2010) | Self-reported fragility and nonfragility fractures in HIV+ PoM versus HIV– PoM | HR: 1.5 (1.1 to 2.2)a | Older age, white race, HIV/HCV co-infection, higher serum creatinine |
| Yin et al. (2012) d | Self-reported fragility and nonfragility fractures in HIV+ PoM and perimenopausal versus HIV+ PrM | HR: 5.8 (1.4 to 23.3)a | Bisphosphonate use, HIV/HCV co-infection, current smoking, glucocorticoid use |
Note. ART = antiretroviral therapy; BMD = bone mineral density; BMI = body mass index; FN = femoral neck; HCV = hepatitis C virus; HIV+ = HIV-infected; HIV– = HIV uninfected; HR= hazard ratio; LS = lumbar spine; OR = odds ratio; PoM = postmenopausal; PeriM = perimenopausal; PrM = premenopausal; PR = prevalence ratio.
a
Unadjusted model.
b
Calculated by reviewer (YC) from information available in article.
c
Study population limited to postmenopausal women.
d
Study population limited to HIV-infected ART-naïve women.