期刊
INTERNATIONAL JOURNAL OF STD & AIDS
卷 33, 期 14, 页码 1183-1192出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/09564624221130129
关键词
AIDS; HIV; prevention; antiretroviral therapy; screening
This study aimed to explore the risk of bone loss in HIV PrEP patients receiving TDF-FTC therapy and address the incidence of HIV infection. The results showed that 3% of patients had osteopenia/osteoporosis, and high adherence to TDF-FTC was significantly associated with a higher risk of bone loss. The study suggested the need for regular check-ups for bone loss.
Background Tenofovir-Emtricitabine (TDF-FTC) is known to cause bone loss in about 1-3% of HIV treated patients. Current studies lack evidence in minority groups and long-term bone loss effects in PrEP patients. Setting To address the risk of osteopenia/osteoporosis in patients on TDF-FTC therapy for HIV PrEP and to address the breakthrough incidence of HIV. Methods A retrospective analysis was performed in Kaiser Permanente patients from 2012-2021. Patients on TDF-FTC for PrEP without any prior history of osteopenia/osteoporosis (N = 7698) were analyzed to determine the relationship between PrEP adherence and osteopenia/osteoporosis. Descriptive statistics and Cox proportional hazards model were used to compare and analyze patient characteristics between those who developed osteopenia/osteoporosis and those who didn't. Results 3% were found to have osteopenia/osteoporosis. Patients who developed osteopenia/osteoporosis were more likely to have a proportion of days covered (PDC) ratio >= 90%, older, had history of Hep B, DM, CVD, CKD, hypertension, and baseline eGFR >= 90 mL/min/1.73 m(2). Kaplan-Meier curve showed the event-free rate of osteopenia/osteoporosis decreased with time, with a greater reduction in patients with high adherence. Survival analysis showed only PDC of >= 90% was significantly associated with the risk of osteopenia/osteoporosis when adjusted. No incidence of HIV infection was detected. Conclusions This retrospective cohort analysis showed that TDF-FTC offered superior PrEP protection. Although high PrEP adherence ensured protection from HIV infection, it was significantly associated with a higher risk of developing osteopenia/osteoporosis. These findings suggest that routine check-ups for osteopenia/osteoporosis may be needed.
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