Bone alterations in hepatitis C virus infected patients |
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| Authors: | Ricardo Pelazas-González Emilio González-Reimers María Remedios Alemán-Valls Francisco Santolaria-Fernández Javier López-Prieto Antonieta González-Díaz Juan Luis Gómez-Sirvent María José de la Vega-Prieto |
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| Affiliation: | 1. Servicio de Medicina Interna, Hospital Universitario, Universidad de La Laguna, Tenerife, Canary Islands, Spain;2. Servicio de Medicina Nuclear, Hospital Universitario, Universidad de La Laguna, Tenerife, Canary Islands, Spain;3. Servicio de Laboratorio, Hospital Universitario, Universidad de La Laguna, Tenerife, Canary Islands, Spain;1. Mario Negri Institute for Pharmacological Research, Milan, Italy;2. Dipartimento di Scienze Cliniche e di Comunità, IRCCS Maggiore Hospital Foundation, Milan, Italy;3. Internal Medicine I, Policlinico IRCCS San Donato, University of Milan, Italy;4. Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Italy;5. Geriatric Unit, Spedali Civili, Department of Medical and Surgery Sciences, University of Brescia, Italy;6. Department of Internal Medicine, University of Perugia, Italy;7. Scientific Direction, IRCCS Maggiore Hospital Foundation, Milan, Italy;1. Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, MN;2. Resident, Department of Anatomic/Clinical Pathology, Mayo Clinic, Rochester, MN;3. Associate Medical Director and Senior Pathologist, Foundation Medicine, Cambridge, MA;4. Senior Scientist, Foundation Medicine, Cambridge, MA;6. Consultant, Department of Anatomic Pathology, Mayo Clinic, Rochester, MN;5. Chair and Consultant, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, MN;1. Pediatric Clinic 2, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan Italy;2. Emergency Unit, Clinica Pediatrica De Marchi, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico, Milan, Italy;1. Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan;2. Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan |
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| Abstract: | Background and aimsMost studies have shown that patients with chronic hepatitis C virus (HCV) infection are affected by osteoporosis. However, liver function impairment and deranged nutrition may both play a role in the bone alterations observed. In some works no osteoporosis was found, and some cases of osteosclerosis have been reported. The aim of the study is to assess bone alterations in treatment-naïve, well-nourished HCV patients, in order to discern whether or not HCV infection causes osteoporosis.MethodsWhole-body bone densitometry and assessment of T-score at lumbar spine and hip were performed to 40 patients and 40 age‐ and sex-matched controls, with a Lunar Prodigy Advance (General Electric, Piscataway, NJ, USA). All the patients underwent liver biopsy. Nutritional evaluation was performed by subjective nutritional assessment, body mass index (BMI), and densitometric assessment of total lean mass and total fat mass. Serum osteocalcin, osteoprotegerin, RANKL, PTH, crosslaps, vitamin D3, testosterone, IGF-1, and estradiol were determined.ResultsPatients did not show differences in total bone mineral density (BMD) or T-score with controls. On the contrary, about a third of them showed positive T scores. Patients showed lower IGF-1, vitamin D3 and testosterone, but higher telopeptide levels, and a trend to higher osteoprotegerin levels. Multivariate analyses disclosed that age, sex, and total lean mass were the only parameters independently related with BMD.ConclusionsTherefore, chronic HCV infection in well nourished patients with preserved liver function does not cause osteoporosis. |
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