Avaliação da densidade mineral óssea e composição corporal por absorciometria por dupla emissão de raios x em pessoas que vivem com HIV atendidas na Fundação De Medicina Tropical Dr Heitor Vieira Dourado

Abstract

HIV infection and the initiation of antiretroviral therapy (ART) are consistently associated with an increased risk of bone fractures. With the initiation of ART, there is an acute loss of bone mineral density (BMD) within the first 24 to 48 weeks, followed by stabilization over time. Prolonged viral infection and ART use are associated with osteoarticular changes and a growing decrease in BMD. Although HIV serology is not directly related to osteoporosis, people living with HIV/AIDS (PLWHA) are also at risk for this condition. Medications such as corticosteroids and anticonvulsants can increase this risk, and some medications used to treat osteoporosis may interact with antiretrovirals. Osteoporosis is a public health issue that primarily affects postmenopausal women, but it can also affect men and younger women. PLWHA on continuous ART use appear to have an increased risk of developing bone fragility. At the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), a reference center for HIV/AIDS in the Amazonas region, there is currently no protocol that includes BMD analysis to prevent bone fractures, nor body composition analysis to assess the prevalence of lipodystrophy and metabolic alterations in this population. This study aims to contribute to the creation of regional public health policies that include strategies tailored to the specific needs of PLWHA. PLWHA with serological confirmation, of both sexes, aged 50 and over, were recruited from the outpatient clinic at FMT-HVD. Among the 38 individuals in the PLWHA group, a prevalence of bone demineralization (osteopenia and osteoporosis) was observed in 32 (84.2%) participants, while in the seronegative group, the prevalence was 18% (7/38). The results of this study reinforce the high prevalence of bone demineralization among PLWHA. The evidence of osteopenia or osteoporosis in 84.2% of participants highlights the urgency of specialized attention to the bone health of these individuals. This study emphasizes the importance of a preventive approach to bone health in PLWHA, aiming not only at treating HIV but also at preserving bone health and reducing the risk of debilitating musculoskeletal conditions.