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Markers of bone turnover are elevated in patients on antiretrovirals independent of the substance used


Osteoporosis and bone fractures are correlated to antiretroviral treatment. It is not clear, if some substances inherit greater risk of bone loss than others.


We measured pyridinoline, desoxipyridinoline crosslinks and bone specific alkaline phosphatase in 108 HIV positive patients. We compared patients with and without antiretroviral treatment. We then analysed patients with vs. without tenofovir and patients with PI vs NNRTI use.


Bone specific alk. phosphatase, pyridonoline and desoxipiridinoline crosslinks and were significantly higher in patients with ART compared with patients without ART: 25.17 vs 13.22 pg/L (p < 0.001); 83.64 vs 51.23 nmol/mmol (p < 0.001) and 16.38 vs 9.68 nmol/mmol (p<0.001)respectively. In contrast, no difference was found in patients with vs. without tenofovir 26.25 vs 20.18 pg/l (p =0.08); 80.74 vs 85.83 nmol/mmol (p=0.42) and 19.36 vs 14.00 nmol/mmol (p=0.13) respectively. Comparison between patients with proteinase inhibitor vs non-nucleoside inhibitor yielded no difference either 23.07 vs 26.49pg/l (p=0.33); 94.31 vs 80.65 nmol/mmol (p=0.34) and 18.18 vs 16.29 nmol/mmol (p= 0.52).


Markers for bone turn over are higher in treated vs untreated patients. No difference concerning tenofovir use or proteinase inhibitor vs. non-nucleoside inhibitor use could be found.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Piso, R., Rothen, M., Rothen, J. et al. Markers of bone turnover are elevated in patients on antiretrovirals independent of the substance used. JIAS 13 (Suppl 4), P97 (2010).

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