Factors influencing bone mineral density in ARV-naive patients at Sanglah Hospital, Bali.

Aim: to evaluate factors which influence bone mineral density in ARV-naive patients in Sanglah Hospital, Bali.
Methods: a cross-sectional BMD measured by dual X-ray absorptiometry at the lumbar spine (LS) and femoral neck (FN) in 73 ARV-naive HIV-infected patients in out patient clinic of Sanglah Hospital, consecutively, from January to June 2012. Inclusion criteria are ARV-naive HIV-infected patients age 13-50 year old. The relationship among factors influence BMD, CD4 level, HIV RNA, HIV stage (WHO) analysed with Anova and Spearman's correlation test.
Results: this study involved 49 males and 24 females. Mean age was 33.08±8.29. Mean CD4 was 144.71±143.40 cell/mmc with the lowest CD4 is 1. Mean viral load (VL) was 272.330±282.990 copies/ml, the lowest VL 400 copies/ml, and the highest 750 000 copies/ml. Low BMD found in 32/73 (43.8%). Osteopenia and osteoporosis were diagnosed in 26/73 (35.6%) and 6/73 (8.2%). 13 (40.6%) of the low BMD cases occurred on the age group 21-30 year. Significant correlation found between low BMD with HIV stage (r=0.337; p<0.001).
Conclusion: patients with higher HIV stage have higher risk of low BMD in ARV-naive patient. Further study is needed to evaluate correlation of low BMD with its risk factors.