HIV/AIDS患者HAART治疗后骨密度变化的研究

目的探讨HAART治疗后人类免疫缺陷病毒感染/获得性免疫缺陷综合征(human immunodeficiency virus infection/acquired immune deficiency syndrome,HIV/AIDS)患者骨密度的变化。方法选取2014年至2015年北京地坛医院收治的170例HIV感染者,根据治疗时间将患者分为4组,未接受HAART治疗组,接受HAART治疗1年组,2年组,3年及以上组,以20名健康志愿者为对照组,收集年龄、体重、身高、骨代谢指标(包括血浆OPG、RANKL)水平,流式技术检测CD4+T细胞绝对计数,使用PCR仪检测血浆病毒载量,通过定量跟骨超声骨密度仪测量患者左足跟骨骨密度,比较不同组之间的检测结果。结果HAART治疗后患者的CD4+T细胞绝对计数、血浆RANKL水平升高。治疗3年组跟骨骨密度值显著低于未治疗组(P0.05)。治疗1~2年组BMD Z值与治疗3年组差异无统计学意义。跟骨骨密度与HAART时间呈负相关。结论青年人群中,接受HAART治疗后HIV患者骨密度降低,不同治疗时间段骨密度具有明显差异,需定期复查骨密度。

The research of bone mineral density in HIV/AIDS patients after highly active antiretroviral therapy

Objective To evaluate the change of bone mineral density (BMD) after highly active antiretroviral therapy in patients with human immunodeficiency virus infection/acquired immune deficiency syndrome (HIV/AIDS). Methods A total of 166 HIV/AIDS patients in out-patient clinic of Beijing Ditan Hospital were selected from 2014 to 2015. According to the treatment time, the patients were divided into four groups, untreated group, HAART therapy 1 year group, 2-year group, and 3-year and above group. Twenty healthy volunteers were as control group. Data including age, body weight, height, and bone metabolic indexes (serum levels of OPG and RANKL) were collected. CD4 level was measured using flow cytometry. Virus loading was examined using PCR. BMD of the left heel was measure with a ultrasound densitometry. The results among the groups were compared Results After HAART therapy CD4 + T cells and plasma RANKL level of the patients increased. BMD was significantly lower in HAART over 3-year group than that in untreated group (P<0.05). BMD Z score of HAART 3-year group was not different comparing to that of HAART l-year and 2-year group. BMD was negatively correlated with HAART duration. Conclusion BMD decreases in young people after HAART therapy. BMD may change during the treatment period. It is necessary to examine BMD on time.