Interruption or deferral of antiretroviral therapy reduces markers of bone turnover compared with continuous therapy: The SMART Body Composition substudy

J. Hoy, B. Grund, M. Roediger, K.E. Ensrud, I. Brar, R. Colebunders, N. De Castro, M. Johnson, A. Sharma, A. Carr

    Research output: Contribution to journalA1: Web of Science-article

    Abstract

    Bone mineral density (BMD) declines significantly in HIV patients on antiretroviral therapy (ART). We compared the effects of intermittent versus continuous ART on markers of bone turnover in the Body Composition substudy of the Strategies for Management of AntiRetroviral Therapy (SMART) trial and determined whether early changes in markers predicted subsequent change in BMD. For 202 participants (median age 44 years, 17% female, 74% on ART) randomised to continuous or intermittent ART, plasma markers of inflammation and bone turnover were evaluated at baseline, months 4 and 12; BMD at the spine (dual X-ray absorptiometry [DXA] and computed tomography) and hip (DXA) was evaluated annually. Compared to the continuous ART group, mean bone-specific alkaline phosphatase (bALP), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), N-terminal cross-linking telopeptide of type 1 collagen (NTX), and C-terminal cross-linking telopeptide of type 1 collagen (betaCTX) decreased significantly in the intermittent ART group, whereas RANKL and the RANKL:osteoprotegerin (OPG) ratio increased (all p
    Original languageEnglish
    JournalJournal of Bone and Mineral Research
    Volume28
    Issue number6
    Pages (from-to)1264-1274
    Number of pages11
    ISSN0884-0431
    DOIs
    Publication statusPublished - 2013

    Keywords

    • Viral diseases
    • HIV
    • AIDS
    • HAART
    • Antiretrovirals
    • Health impact
    • Bone mineral density
    • Prediction
    • Intermittent treatment
    • Inflammation
    • Alkaline phosphatase
    • Osteocalcin
    • Hip
    • Spine
    • Follow-up
    • USA
    • America-North
    • Australia
    • Pacific
    • Spain
    • Europe-South

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