Administering a single dose of osteoporosis drug Zoledronic Acid can help prevent bone loss in patients diagnosed with Human Immunodeficiency Virus (HIV).
HIV patients are usually recommended to undergo antiretroviral therapy (ART), which has decreased skeletal health as a common side effect. Studies show that bone mineral density decreases by as much as 6 percent during the first year of ART. Such bone loss is similar to that of women during the early stages of menopause.
Previous researches fail to determine the direct effects of ART on bone cells because tests performed on a petri dish and in living organisms fail to repeat the same effects on HIV patients. This then suggests that bone loss in these patients may not be due to ART.
Previous Animal Study
The authors started their quest by studying what really causes bone loss in HIV patients receiving ART. This study, published in the journal Nature Communications in September 2015, involved rat models.
The findings show that bone loss linked to ART may be because of inflammatory processes following the recovery of the immune system, instead of the actual ART medicines.
The authors also injected the subjects with a single dose of zoledronic acid, which prevented bone loss while preserving the recovering immune system.
Human Study
Months after the animal study, the same researchers replicated the zoledronic acid treatment to humans. All participants, aged 30-50 years old, had no history of immunological conditions aside from HIV. They also had normal blood tests results.
The authors excluded those with history of osteoporosis, recent gastrointestinal bleeding, active peptic ulcer disease, upcoming invasive dental treatment, and those who are pregnant or breastfeeding. Out of more than 300 individuals, 63 were deemed eligible for the study.
For the entire 48-week study, the participants were randomly assigned to receive either ART with placebo or ART with zoledronic acid.
The zoledronic acid group showed a 73 percent and 65 percent reduction in bone loss after the 12th and 24th week. Meanwhile, although patients in the placebo group showed a surprising compensatory bone formation, almost all of them exhibited increased bone loss.
The authors also looked into the differences in outcomes between genders. Bone loss was higher in men than in women in the placebo group. In the zoledronic acid group, men had higher protection against bone loss than women.
Zoledronic acid did not have any effects on immunologic response.
"We are encouraged that our protocol was able to prevent bone loss in HIV patients on ART therapy," says Igho Ofotokun, a co-author. He added that the effects were observed from the early phase of the experiment until the 48th week, which is when bone loss due to ART is said to be most intense.
This new study was presented at the 2016 Conference on Retroviruses and Opportunistic Infections, which happened last Tuesday.
Bone Loss And HIV
Almost two-thirds of HIV patients show bone loss, with 15 percent of the subjects exhibiting osteoporosis.
HIV patients are also more at risk of bone and hip fracture than the general population by two to fourfold and up to ninefold respectively.
Photo: German Tenorio | Flickr
