Bone Mineral Density in a Tenofovir PrEP Trial
Author Information
Author(s): Liu Albert Y., Vittinghoff Eric, Sellmeyer Deborah E., Irvin Risha, Mulligan Kathleen, Mayer Kenneth, Thompson Melanie, Grant Robert, Pathak Sonal, O'Hara Brandon, Gvetadze Roman, Chillag Kata, Grohskopf Lisa, Buchbinder Susan P.
Primary Institution: San Francisco Department of Public Health
Hypothesis
What is the baseline prevalence of low bone mineral density (BMD) and the effect of tenofovir on BMD in men who have sex with men (MSM) in a PrEP trial?
Conclusion
Ten percent of HIV-negative MSM had low BMD at baseline, and TDF use resulted in a small but statistically significant decline in BMD at the total hip and femoral neck.
Supporting Evidence
- 20 participants (10%) had low BMD at baseline.
- Low BMD was associated with amphetamine and inhalant use.
- Men taking multivitamins, calcium, or vitamin D were less likely to have low BMD.
Takeaway
Some men who are not infected with HIV already have weak bones, and taking a medicine to prevent HIV can make their bones a little weaker.
Methodology
The study evaluated the prevalence of low BMD using DEXA scans in a cohort of 210 HIV-uninfected MSM and assessed the effects of TDF on BMD in a longitudinal cohort of 184 enrolled men.
Potential Biases
The convenience sample may not reflect the broader population of MSM.
Limitations
The study was conducted at a single site with a relatively small sample size, limiting generalizability and multivariable analysis.
Participant Demographics
The majority of participants were white men aged 18-60 who reported anal sex with men in the past 12 months.
Statistical Information
P-Value
p=0.004 for femoral neck, p=0.003 for total hip
Confidence Interval
95% CI 0.4–1.9% for femoral neck, 95% CI 0.3–1.3% for total hip
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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