Print E-mail
Volume 47, Number 2, April 2014

Reduced bone mineral density among HIV-infected patients in Taiwan: Prevalence and associated factors


Mao-Song Tsai, Chien-Ching Hung, Wen-Chun Liu, Kuan-Lin Chen, Mao-Yuan Chen, Szu-Min Hsieh, Wang-Huei Sheng, Hsin-Yun Sun, Tiffany T.F. Shih*

Received: April 16, 2012    Revised: August 22, 2012    Accepted: August 27, 2012   


Corresponding author:

Department of Medical Imaging and Radiology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
Corresponding Author InformationCorresponding author. Department of Medical Imaging and Radiology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan. 


Background and purpose: 

Reduced bone mineral density (BMD) is an emerging threat to the successful long-term management of human immunodeficiency virus (HIV) infection among patients with access to combination antiretroviral therapy (cART). Data on the prevalence and associated factors of reduced BMD in Asian populations remain scarce. 



From March 2002 to April 2006, a cross-sectional survey was conducted among HIV-infected patients aged ≥ 20 years at the National Taiwan University Hospital. BMD of the lumbar spine was measured with the use of dual-energy X-ray absorptiometry. Osteopenia was defined as a BMD T-score between −1.0 and −2.5, and osteoporosis was defined as a BMD T-score ≤ −2.5. Linear and ordinal logistic regression analyses were performed. 



Among 320 patients with a median age of 37.3 years, body mass index (BMI) of 21.4kg/m2 and 94.4% on cART, osteopenia and osteoporosis were diagnosed in 35.6% and 3.8%, respectively. On multivariate linear analysis, factors associated with reduced BMD were increasing age (p=0.006), longer duration on antiretroviral therapy (p=0.007), and a decreasing BMI (p=0.002). Using ordinal logistic regression, being underweight with a body mass index (BMI)<18.5kg/m2 was independently associated with reduced BMD (proportional odds ratio, 4.12; 95% confidence interval, 1.93–8.82). 



Reduced BMD was prevalent among HIV-infected Taiwanese adults on cART. Increased age, lower BMI, and exposure to antiretroviral therapy were significantly associated with decrease of BMD.


Key words:

Antiretroviral therapy, Body mass index, Bone mineral density, HIV, Prevalence