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Background Low bone mass and high bone turnover have been reported in HIV-infected individuals, both as a consequence of HIV infection itself, as well as from treatment with highly active antiretroviral therapy (HAART). The purpose of this study is to evaluate the impact of HAART on bone mineral density and bone turnover in HIV-1 infected Chinese patients. Methods Forty HIV-1 infected patients were enrolled in this study; all patients were followed through 48 weeks, and 17 patients completed 96 weeks. Bone mineral density (BMD), procollagen type 1 N-terminal propeptide (P1NP), collagen type 1 cross-linked C-telopeptide (β-CTX), parathyroid hormone (PTH), and 25-OH vitamin D levels were measured at baseline, 48 and 96 weeks. Baseline measurements were compared with an age-, gender-, and BMI-matched healthy control population. Results At baseline, raw BMD in the lumbar spine of HIV-1 infected patients was significantly lower than that of healthy controls (1.138 ± 0.112 g/cm2 vs. 1.195 ± 0.139 g/cm2, p = 0.047). During the first 48 weeks after initiating HAART, BMD of lumbar spine, femoral neck, and total hip decreased significantly in HIV-1 infected patients, with annual percent decline ranging from 1.78-3.28%. However, from week 48 to 96, BMD remained stable. Baseline levels of β-CTX (0.31 ± 0.16 ng/mL vs. 0.42 ± 0.19 ng/mL, p = 0.008) and P1NP (32.96 ± 14.00 ng/mL vs. 55.82 ± 26.87 ng/mL, p = 0.05) were lower in HIV-infected patients compared with controls, respectively. Both β-CTX and P1NP levels increased after onset of HAART until week 48, and remained elevated during the next 48 weeks. 25-OH vitamin D in HIV-infected patients was lower at baseline compared to healthy controls, but this difference was not statistically significant. PTH, however, was higher in HIV patients at baseline, and showed a significant increase throughout the study. Conclusions Chinese adults with HIV-1 infection have low bone turnover prior to HAART as well as lower raw BMD of the lumbar spine compared with healthy controls, with further bone loss occurring following the initiation of HAART. The long-term clinical implications of these findings remain unclear at this time.

To evaluate the influence of long-term nucleotide reverse transcriptase inhibitors (NRTIs) on lipids metabolism in HIV/AIDS patients and correlating clinical factors.A total of 118 HIV/AIDS patients were divided into 3 groups: untreated group (40 patients), highly active antiretroviral therapy (HAART) for 1 - 2 years group (37 patients) and HAART over 5 years group (41 patients), with 20 healthy individuals as the control group. Clinical lipodystrophy (LD) was defined as concordance between patient's report of change and physical examination. Fat mass (FM) was measured by dual-energy X-ray absorptiometry (DXA).There was no significant difference in the incidence of LD between HAART for 1 - 2 years group and HAART over 5 years group (51.2% vs 40.5%, P = 0.345). The prevalence of LD was 2.4 folds with stavudine (d4T) treatment compared with zidovudine (AZT)-containing regimens (61.6% vs 23.5%, P = 0.001). Based on DXA measurements, FM of total body and limbs were significantly lower in the HAART over 5 years group than that in the control group, the untreated group and the HAART for 1 - 2 years group (P0.05). Trunk FM was significantly lower in the HAART over 5 years group than the untreated group and the HAART for 1 - 2 years group (P0.05). FM of total body and trunk were significantly lower in patients without LD in the HAART over 5 years group than patients without LD in the HAART for 1 - 2 years group (P0.05). FM was correlated positively with body weight and BMI. Limbs FM was correlated negatively with peripheral blood triglyceride concentration.HIV/AIDS patients with NRTIs therapy have high prevalence of LD, which mainly occurs 1 - 2 years after therapy, and increases with d4T treatment compared with AZT-containing regimens. There was no significant difference in the incidence of LD between the HAART for 1 - 2 years group and the HAART over 5 years group. FM was significantly decreased after long-term HAART in the patients with or without LD. DXA can evaluate LD objectively and guide further clinical treatment.

To evaluate the influence of highly active antiretroviral therapy (HAART) on bone mineral density (BMD) in HIV/AIDS patients and correlating clinical factors.149 HIV patients were divided into 3 groups:untreated group with 41 patients, HAART for 1-2 years group with 60 patients, HAART over 5 years group with 48 patients; 20 healthy individuals included as a control group. BMD-T score and BMD-Z score were measured by dual-energy X-ray absorptiometry (DXA).BMD-Z score of right hip was significantly lower in HAART over 5 years group (0.16 ± 0.82) than untreated group (0.61 ± 1.09) (P = 0.039). BMD-Z score of right femoral neck was significantly lower in HAART over 5 years group (-0.002 ± 0.87) than untreated group (0.55 ± 1.08) (P = 0.012). BMD-Z score of HAART for 1-2 years group was not significantly decreased. BMD-Z score of right hip and right femoral neck were correlated negatively with HAART duration. The incidence of osteopenia/osteoporosis in HAART for 1 - 2 years group (31.7%) and HAART over 5 years group (31.3%) were significantly higher than untreated group (12.2%) (P0.05). Body weight was revealed as a risk factor of osteopenia/osteoporosis.BMD of right hip and right femur neck were significantly lower in HAART over 5 years group. The incidence of osteopenia/osteoporosis were significantly higher in patients receiving HAART. BMD were correlated negatively with HAART duration. Patients in long-term HAART combined with risk factors such as old age or lower body weight should be checked by DXA regularly.

To investigate the cough-relieving, analgesic and antibiotic effects of durian shell extract (DSE) in relieving cough and its analgesic and antibiotic effects.The effect of DSE in relieving cough was assessed in mice challenged with ammonia and SO(2) to induce coughing. The analgesic and antibiotic effects of DSE in mice were evaluated by hot plate test and twisting reaction induced by acetic acid, and by minimal inhibitory concentration (MIC) and disc-agar diffusion tests, respectively.Compared with the control group, the mice treated with 300 and 900 mg/kg DSE showed significantly prolonged latency with decreased number of coughing induced by ammonia and SO(2), and the effect was dose-dependent. DSE markedly prolonged the latency and decreased the twisting number of the mice induced by acetic acid without affecting the pain threshold in hot plate test. DSE produced no significant inhibitory effects against Staphylococcus aureus, Staphylococcus epidermidis, or E. coli, and showed a week inhibition against Bacillus aeruginosus.DSE shows obvious effect in relieving cough and produces better analgesic effect against chemical factor-induced pain than against physical agent-induced pain sensation. DSE has a moderate inhibitory effect against Bacillus aeruginosus.