Bone mass, body composition and vitamin D status of ARV-naïve, urban, black South African women with HIV infection, stratified by CD4 count

Summary This is the first report examining vitamin D status and bone mass in African women with HIV infection using dual-energy X-ray absorptiometry (DXA) with an appropriate HIV-negative control group. Unlike previous publications, it demonstrates no difference in bone mineral density (BMD) or vitamin D status in HIV-positive patients, at different disease stages, vs. HIV-negative subjects. Introduction Low bone mass and poor vitamin D status have been reported among HIV-positive patients; suggesting HIV or its treatment may increase the risk of osteoporosis, a particular concern for women in countries with high HIV prevalence such as South Africa. We describe bone mass and vitamin D status in urban premenopausal South African women, who were HIV positive but not on antiretroviral therapy (ARV). Methods This study is a cross-sectional measurement of BMD and body composition by DXA and vitamin D status by serum 25-hydroxyvitamin D (25(OH)D) concentration. Subjects were recruited into three groups: HIV negative ( n = 98) and HIV positive with preserved CD 4 cell count (non-ARV; n = 74) or low CD 4 cell counts prior to ARV initiation (pre-ARV; n = 75). Results The mean (standard deviation (SD)) age of women was 32.1 (7.2) years. Mean CD 4 (SD) counts (×10 6 /l) were 412 (91) and 161 (69) in non-ARV and pre-ARV groups ( p 0.05); the mean (SD) cohort 25(OH)D being 60 (18) nmol/l. Conclusion Contrary to previous studies, these HIV-positive women did not have lower BMD or 25(OH)D concentrations than HIV-negative controls, despite the pre-ARV group being lighter with lower BMI.