Skip to content

Advertisement

  • Poster presentation
  • Open Access

Quantitative ultrasound (QUS) in HIV-infected patients: a reliable and low-cost technique for bone health assessment

  • 1,
  • 1,
  • 1,
  • 1,
  • 2,
  • 2,
  • 1 and
  • 1
Journal of the International AIDS Society201013 (Suppl 4) :P98

https://doi.org/10.1186/1758-2652-13-S4-P98

  • Published:

Keywords

  • Stiffness Index
  • 25OH Vitamin
  • Broadband Ultrasound Attenuation
  • Quantitative Ultrasound Index
  • Immune Activation Marker

Objective

Bone demineralization is common in HIV-infected subjects. Reliable and low cost methods would be useful in order to identify and monitor bone alterations both in older and younger HIV+ patients. Recent data in normal population suggest that bone mineral quality (BMQ), assessed by a quantitative ultrasound (QUS) technique, could be an early marker of osteopenia/osteoporosis. Therefore, we investigated the usefulness of QUS in order to study bone health assessment in HIV-infected adults.

Methods

37 HIV-infected patients and 44 HIV-negative controls, matched for sex and age, were enrolled. Bone health was measured using classical dual energy x-ray adsorptiometry (DEXA) of spine and hip and calcaneal QUS. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) and quantitative ultrasound index (QUI)/stiffness index (SI) were assessed by QUS. Data were correlated with CD4+ T-cell count, HIV load, years of disease, immune activation markers (DR+CD38+CD4+ and DR+CD38+CD8+), 25OH vitamin D. Nonparametric Mann-Whitney test and Spearman correlation were used for statistical analysis.

Results

5 patients were viremic (ARV-naïve), while the remaining subjects were virologically ARV-suppressed. In the latter group, 17 were in treatment with PI and 16 with NNRTI. The mean nadir CD4 was 665/mmc. Comparable QUS parameters were found in HIV+ subjects and controls as well as between NNRTI- and PI-based therapies. No difference was seen in patients treated with TDF. A significant decrease of QUI was found in HIV+ patients aged >48 years (p=0.012). A correlation between QUI and age in HIV+ patients was seen (p=0.047). No correlation was found between QUS and CD4 nadir, as well as between QUS and immune activation markers. No difference was observed between cases and controls for vitamin D levels which were decreased in both groups. However, a significant correlation between vitamin D level and age was found only in HIV+ population (p=0.022), other than between vitamin D and years of infection (p=0.0142). Moreover, a strong correlation between QUI and DEXA values was observed (p=0.001).

Conclusions

QUS parameters are closely related to the structural and elastic properties of bone and they provide important information about bone quality and strength. Therefore, in HIV+ people QUS might be a simple and inexpensive technique in order to monitor bone health and identify early signs of bone damage, independently from vitamin D levels.

Authors’ Affiliations

(1)
Sapienza University, Polo Pontino, Infectious Diseases, Latina, Italy
(2)
SM Goretti Hospital, Latina, Italy

References

  1. Guglielmi G, Scalzo G, de Terlizzi F, Peh WC: Quantitative ultrasound in osteoporosis and bone metabolism pathologies. Radiol Clin North Am. 2010, 4: 577-88. 10.1016/j.rcl.2010.02.013.View ArticleGoogle Scholar
  2. Mora S, Viganò A, Cafarelli L, et al: Applicability of quantitative ultrasonography of the radius and tibia in HIV-infected children and adolescents. J Acquir Immune Defic Syndr. 2009, 51: 588-92. 10.1097/QAI.0b013e3181adc838.View ArticlePubMedGoogle Scholar

Copyright

© Mastroianni et al; licensee BioMed Central Ltd. 2010

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 (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Advertisement