โรคกระดูกพรุนในผู้ป่วยติดเชื้อเอชไอวี
DOI:
https://doi.org/10.14456/dcj.2014.9คำสำคัญ:
โรคกระดูกพรุน, ความหนาแน่นกระดูก, เชื้อเอชไอวีบทคัดย่อ
ปัจจุบันผู้ป่วยติดเชื้อเอชไอวีได้รับยาต้านไวรัสที่มีประสิทธิภาพ ส่งผลให้ผู้ป่วยมีอายุขัยใกล้เคียงกับคนปกติ พบการลดลงของความหนาแน่นกระดูกมากขึ้น นำไปสู่ภาวะกระดูกบางและโรคกระดูกพรุน ทำให้เกิดภาวะแทรกซ้อนที่รุนแรง เช่น กระดูกหัก เป็นต้น ปัจจัยเสี่ยงที่จำเพาะต่อการลดลงของความหนาแน่นกระดูกในผู้ป่วยติดเชื้อเอชไอวีมีหลายปัจจัย ได้แก่ การติดเชื้อเอชไอวี การติดเชื้อไวรัสตับอักเสบซีร่วมกับไวรัสเอชไอวี ยาต้านไวรัส โดยเฉพาะยา tenofovir ยาที่ใช้รักษาภาวะแทรกซ้อนในผู้ป่วยติดเชื้อเอชไอวีและการเปลี่ยนแปลงของระดับฮอร์โมนและแคลเซียม ดังนั้น การติดเชื้อเอชไอวีจึงถือเป็นปัจจัยเสี่ยงต่อโรคกระดูกพรุน และมีคำแนะนำให้มีการตรวจความหนาแน่นกระดูกในผู้ป่วยติดเชื้อเอชไอวีหญิงที่หมดประจำเดือน และผู้ป่วยติดเชื้อเอชไอวีชายที่อายุมากกว่า 50 ปี ทุกราย ส่วนการรักษาและการป้องกันประกอบด้วย การเปลี่ยนแปลงกิจวัตรประจำวัน การรักษาด้วยยา bisphosphonate แคลเซียม และวิตามินดี ดังนั้น ความรู้เกี่ยวกับโรคและปัจจัยเสี่ยงเป็นสิ่งที่สำคัญ เพื่อให้แพทย์และบุคลากรทางการแพทย์สามารถให้การวินิจฉัยและป้องกันโรคตั้งแต่ระยะต้น รวมถึงให้คำแนะนำการดูแลรักษาที่เหมาะสมเพื่อป้องกันการเกิดภาวะแทรกซ้อนต่อไป
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เอกสารอ้างอิง
1. Borderi M, Gibellini D, Vescini F, De Crignis E, Cimatti L, Biagetti C, et al. Metabolic bone disease in HIV infection. AIDS 2009;23:1297.
2. World Health Organization. Assessment of fracture risk and its application to screening for post-menopausal osteoporosis. Report of a WHO Study Group. World Health Organization technical report series 1994;843:1-129.
3. Brown TT, Qaqish RB. Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: a meta-analytic review. AIDS 2006;20:2165.
4. Bonjoch A, Figueras M, Estany c, Perez- Alvarez N, Rosales J, del Rio L, et al. High prevalence of and progression to low bone mineral density in HIV-infected patients: a longitudinal cohort study. AIDS 2010;24:2827.
5. Cazanave C, Dupon M, Lavignolle-Aurillac V, Barthe N, Lawson-Ayayi S, Mehsen N, et al. Reduced bone mineral density in HIV-infected patients: prevalence and associated factors. AIDS 2008;22:395.
6. Sittibusaya C, Manosuthi W. Evaluation of bone structure by quantitative ultrasound at Calcaneous in HIV patients at Bumrasnaradura Institute. Disease Control Journal 2004;3:187.
7. Triant VA, Brown TT, Lee H, Grinspoon SK. Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non - HIV- infected patients in a large U.S. healthcare system. J Clin Endocrinol Metab 2008;93:3499.
8. McComsey GA, Huang JS, Woolley IJ, Young B, Sax PE, Gerber M, et al. Fragility fractures in HIV-infected patients: need for better under-standing of diagnosis and management. J Int Assoc Physicians AIDS Care (Chic) 2004;3:86.
9. Stephens EA, Das R, Madge S, Barter J, Johnson MA. Symptomatic osteoporosis in two young HIV-positive African women. AIDS 1999;13:2605.
10. Martin K, Lawson-Ayayi S, Miremont-Salame G, Blaizeau MJ, Balestre E, Lacoste D, et al. Symptomatic bone disorders in HIV-infected patients: incidence in the Aquitaine cohort (1999- 2002). HIV Med 2004;5:421.
11. Young B, Dao CN, Buchacz K, Baker R, Brooks JT; HIV Outpatient Study (HOPS) investigators increased rates of bone fracture among HIV-infected persons in the HIV Outpatient Study (HOPS) compared with the US general population, 2000-2006. Clin Infect Dis 2011;52:1061.
12. Lo Re V 3rd, Volk J, Newcomb cw, Yang YX, Freeman CP, Hennessy S, et al. Risk of hip fracture associated with hepatitis c virus infection and hepatitis c/human immunodeficiency virus coinfection. Hepatology 2012;56:1688.
13. Bolland MJ, Grey AB, Horne AM, Briggs SE, Thomas MG, Ellis-Pegler RB, et al. Bone mineral density remains stable in HA ART- treated HIV-infected men over 2 years. Clin Endocrinol (Oxf). 2007;67:270-5.
14. Jacobson DL, spiegelman D, Knox TK, Wilson IB. Evolution and predictors of change in total bone mineral density over time in HIV-infected men and women in the nutrition for healthy living study. J Acquir Immune Defic Syndr 2008;49:298.
15. Womack JA, Goulet JL, Gibert C, Brandt CA, Skanderson M, Gulanski B, et al. Physiologic frailty and fragility fracture in HIV-infected male veterans. Clin Infect Dis 2013;56:1498.
16. Mueller NJ, Fux CA, Ledergerber B, Elzi L, Schmid P, Dang T, et al. High prevalence of severe vitamin D deficiency in combined antiretroviral therapy-naive and successfully treated Swiss HIV patients. AIDS 2010;24: 1127.
17. Sherwood JE, Mesner OC, Weintrob AC, Hadigan CM, Wilkins KJ, Crum-Cianflone NF, et al. Vitamin D deficiency and its association with low bone mineral density, HIV-related factors, hospitalization, and death in a predominantly black HIV-infected cohort. Clin Infect Dis 2012;55:1727.
18. Manolagas SC, Jilka RL. Bone marrow, cytokines, and bone remodeling. Emerging in-sights into the pathophysiology of osteoporosis. N Engl J Med 1995;332:305.
19. Gibellini D, De Crignis E, Ponti C, Cimatti L, Borderi M, Tschon M, et al. HIV-1 triggers apoptosis in primary osteoblasts and HOBIT cells through TNFalpha activation. J Med Virol 2008;80:1507.
20. Yin MT, Shi Q, Hoover DR, Anastos K, Sharma A, Young M, et ฟ. Fracture incidence in HIV- infected women: results from the women's Interagency HIV Study. AIDS 2010;24:2679.
21. Collier J. Bone disorders in chronic liver disease. Hepatology 2007;46:1271.
22. Duvivier C, Kolta S, Assoumou L, Ghosn J, Rozenberg S, Murphy RL, et al. Greater decrease in bone mineral density with protease inhibitor regimens compared with nonnucleoside reverse transcriptase inhibitor regimens in HIV-1 infected naive patients. AIDS 2009;23:817.
23. Brown TT, McComsey GA, King MS, Qaqish RB, Bernstein BM, da Silva BA. Loss of bone mineral density after antiretroviral therapy initiation, independent of antiretroviral regimen. J Acquir Immune Defic Syndr 2009;51:554.
24. Stellbrink HJ, Orkin C, Arribas JR, Compston J, Gerstoft J, Van Wijngaerden E, et al. Comparison of changes in bone density and turnover with abacavir-lamivudine versus tenofovir-emtricitabine in HIV-infected adults: 48-week results from the ASSERT study. Clin Infect Dis 2010;51:963.
25. Mulligan K, Harris DR, Emmanuel P, Fielding RA, Worrell C, Kapogiannis BG, et al. Low bone mass in behaviorally HIV-infected young men on antiretroviral therapy: Adolescent Trials Network Study 021B. Clin Infect Dis 2012;55:461.
26. Grant PM, Kitch D, McComsey GA, Dube MP, Haubrich R, Huang J, et al. Low baseline CD4 + count is associated with greater bone mineral density loss after antiretroviral therapy initiation. Clin Infect Dis 2013;57:1483.
27. Bedimo R, Maalouf NM, Zhang S, Drechsler H, Tebas P. Osteoporotic fracture risk associated with cumulative exposure to tenofovir and other antiretroviral agents. AIDS 2012;26:825.
28. Gallant JE, Staszewski S, Pozniak AL, Dejesus E, Suleiman JM, Miller MD, et al. Efficacy and safety of tenofovir DF vsstavudine in combination therapy in antiretroviral-naive patients: a 3-year randomized trial. JAMA 2004;292: 191.
29. Earle KE, Seneviratne T, Shaker J, Shoback D. Fanconi's syndrome in HIV+ adults: report of three cases and literature review. J Bone Miner Res 2004;19:714.
30. Perrot S, Aslangul E, Szwebel T, Caillat-Vigneron N, Le Jeunne c. Bone pain due to fractures revealing osteomalacia related to tenofovir- induced proximal renal tubular dysfunction in a human immunodeficiency virus-infected patient. J Clin Rheumatol 2009;15:72.
31. Pedrazzoni M, Vescovi PP, Maninetti L, Michelini M, Zaniboni G, Pioli GP, et al. Effects of chronic heroin abuse on bone and mineral metabolism. Acta Endocrinol (Copenh) 1993; 129:42.
32. Aukrust P, Haug CJ, Ueland T, Lien E, Muller F, Espevik T, et al. Decreased bone formative and enhanced resorptive markers in human immunodeficiency virus infection: indication of normalization of the bone-remodeling process during highly active antiretroviral therapy. J Clin Endocrinol Metab 1999;84:145.
33. Heilman P, Albert J, Gidlund M, Klareskog L, Rastad J, AkerstrOm G, et al. Impaired parathyroid hormone release in human immunodeficiency virus infection. AIDS Res Hum Retroviruses 1994;10:391.
34. McComsey GA, Tebas P, Shane E, Yin MT, Overton ET, Huang JS, et al. Bone disease in HIV infection: a practical review and recommendations for HIV care providers. Clin Infect Dis 2010;51:937.
35. Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 2014;58:1.
36. Garcia-AparicioAM, Munoz Fernandez S, Gonzalez J, Arribas JR, Pena JM, Vazquez JJ, et al. Abnormalities in the bone mineral metabolism in HIV-infected patients. Clin Rheumatol 2006;25:537.
37. Van Den Bout-Van Den Beukel CJ, Fievez L, Michels M, Sweep FC, Hermus AR, Bosch ME, et al. Vitamin D deficiency among HIV type 1 - infected individuals in the Netherlands: effects of antiretroviral therapy. AIDS Res Hum Retroviruses 2008;24:1375.
38. Mondy K, Powderly WG, Claxton SA, Yarasheski KH, Royal M, Stoneman JS, et al. Alendronate, vitamin D, and calcium for the treatment of osteopenia/ osteoporosis associated with HIV in-fection. J Acquir Immune Defic Syndr 2005;38:426.
39. McComsey GA, Kendall MA, Tebas P, Swindells S, Hogg E, Alston-Smith B, et al. Alendronate with calcium and vitamin D supplementation is safe and effective for the treatment of decreased bone mineral density in HIV. AIDS 2007;21:2473.
40. Huang J, Meixner L, Fernandez S, McCutchan JA. A double-blinded, randomized controlled trial of zoledronate therapy for HIV-associated osteopenia and osteoporosis. AIDS 2009;23:51.
41. Bolland MJ, Grey AB, Home AM, Briggs SE, Thomas MG, Ellis-Pegler RB, et al. Annual zoledronate increases bone density in highly active antiretroviral therapy-treated human immunodeficiency virus-infected men: a randomized controlled trial. J Clin Endocrinol Metab 2007;92:1283.
42. Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Washington, DC: The National Academies Press; 2010.
2. World Health Organization. Assessment of fracture risk and its application to screening for post-menopausal osteoporosis. Report of a WHO Study Group. World Health Organization technical report series 1994;843:1-129.
3. Brown TT, Qaqish RB. Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: a meta-analytic review. AIDS 2006;20:2165.
4. Bonjoch A, Figueras M, Estany c, Perez- Alvarez N, Rosales J, del Rio L, et al. High prevalence of and progression to low bone mineral density in HIV-infected patients: a longitudinal cohort study. AIDS 2010;24:2827.
5. Cazanave C, Dupon M, Lavignolle-Aurillac V, Barthe N, Lawson-Ayayi S, Mehsen N, et al. Reduced bone mineral density in HIV-infected patients: prevalence and associated factors. AIDS 2008;22:395.
6. Sittibusaya C, Manosuthi W. Evaluation of bone structure by quantitative ultrasound at Calcaneous in HIV patients at Bumrasnaradura Institute. Disease Control Journal 2004;3:187.
7. Triant VA, Brown TT, Lee H, Grinspoon SK. Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non - HIV- infected patients in a large U.S. healthcare system. J Clin Endocrinol Metab 2008;93:3499.
8. McComsey GA, Huang JS, Woolley IJ, Young B, Sax PE, Gerber M, et al. Fragility fractures in HIV-infected patients: need for better under-standing of diagnosis and management. J Int Assoc Physicians AIDS Care (Chic) 2004;3:86.
9. Stephens EA, Das R, Madge S, Barter J, Johnson MA. Symptomatic osteoporosis in two young HIV-positive African women. AIDS 1999;13:2605.
10. Martin K, Lawson-Ayayi S, Miremont-Salame G, Blaizeau MJ, Balestre E, Lacoste D, et al. Symptomatic bone disorders in HIV-infected patients: incidence in the Aquitaine cohort (1999- 2002). HIV Med 2004;5:421.
11. Young B, Dao CN, Buchacz K, Baker R, Brooks JT; HIV Outpatient Study (HOPS) investigators increased rates of bone fracture among HIV-infected persons in the HIV Outpatient Study (HOPS) compared with the US general population, 2000-2006. Clin Infect Dis 2011;52:1061.
12. Lo Re V 3rd, Volk J, Newcomb cw, Yang YX, Freeman CP, Hennessy S, et al. Risk of hip fracture associated with hepatitis c virus infection and hepatitis c/human immunodeficiency virus coinfection. Hepatology 2012;56:1688.
13. Bolland MJ, Grey AB, Horne AM, Briggs SE, Thomas MG, Ellis-Pegler RB, et al. Bone mineral density remains stable in HA ART- treated HIV-infected men over 2 years. Clin Endocrinol (Oxf). 2007;67:270-5.
14. Jacobson DL, spiegelman D, Knox TK, Wilson IB. Evolution and predictors of change in total bone mineral density over time in HIV-infected men and women in the nutrition for healthy living study. J Acquir Immune Defic Syndr 2008;49:298.
15. Womack JA, Goulet JL, Gibert C, Brandt CA, Skanderson M, Gulanski B, et al. Physiologic frailty and fragility fracture in HIV-infected male veterans. Clin Infect Dis 2013;56:1498.
16. Mueller NJ, Fux CA, Ledergerber B, Elzi L, Schmid P, Dang T, et al. High prevalence of severe vitamin D deficiency in combined antiretroviral therapy-naive and successfully treated Swiss HIV patients. AIDS 2010;24: 1127.
17. Sherwood JE, Mesner OC, Weintrob AC, Hadigan CM, Wilkins KJ, Crum-Cianflone NF, et al. Vitamin D deficiency and its association with low bone mineral density, HIV-related factors, hospitalization, and death in a predominantly black HIV-infected cohort. Clin Infect Dis 2012;55:1727.
18. Manolagas SC, Jilka RL. Bone marrow, cytokines, and bone remodeling. Emerging in-sights into the pathophysiology of osteoporosis. N Engl J Med 1995;332:305.
19. Gibellini D, De Crignis E, Ponti C, Cimatti L, Borderi M, Tschon M, et al. HIV-1 triggers apoptosis in primary osteoblasts and HOBIT cells through TNFalpha activation. J Med Virol 2008;80:1507.
20. Yin MT, Shi Q, Hoover DR, Anastos K, Sharma A, Young M, et ฟ. Fracture incidence in HIV- infected women: results from the women's Interagency HIV Study. AIDS 2010;24:2679.
21. Collier J. Bone disorders in chronic liver disease. Hepatology 2007;46:1271.
22. Duvivier C, Kolta S, Assoumou L, Ghosn J, Rozenberg S, Murphy RL, et al. Greater decrease in bone mineral density with protease inhibitor regimens compared with nonnucleoside reverse transcriptase inhibitor regimens in HIV-1 infected naive patients. AIDS 2009;23:817.
23. Brown TT, McComsey GA, King MS, Qaqish RB, Bernstein BM, da Silva BA. Loss of bone mineral density after antiretroviral therapy initiation, independent of antiretroviral regimen. J Acquir Immune Defic Syndr 2009;51:554.
24. Stellbrink HJ, Orkin C, Arribas JR, Compston J, Gerstoft J, Van Wijngaerden E, et al. Comparison of changes in bone density and turnover with abacavir-lamivudine versus tenofovir-emtricitabine in HIV-infected adults: 48-week results from the ASSERT study. Clin Infect Dis 2010;51:963.
25. Mulligan K, Harris DR, Emmanuel P, Fielding RA, Worrell C, Kapogiannis BG, et al. Low bone mass in behaviorally HIV-infected young men on antiretroviral therapy: Adolescent Trials Network Study 021B. Clin Infect Dis 2012;55:461.
26. Grant PM, Kitch D, McComsey GA, Dube MP, Haubrich R, Huang J, et al. Low baseline CD4 + count is associated with greater bone mineral density loss after antiretroviral therapy initiation. Clin Infect Dis 2013;57:1483.
27. Bedimo R, Maalouf NM, Zhang S, Drechsler H, Tebas P. Osteoporotic fracture risk associated with cumulative exposure to tenofovir and other antiretroviral agents. AIDS 2012;26:825.
28. Gallant JE, Staszewski S, Pozniak AL, Dejesus E, Suleiman JM, Miller MD, et al. Efficacy and safety of tenofovir DF vsstavudine in combination therapy in antiretroviral-naive patients: a 3-year randomized trial. JAMA 2004;292: 191.
29. Earle KE, Seneviratne T, Shaker J, Shoback D. Fanconi's syndrome in HIV+ adults: report of three cases and literature review. J Bone Miner Res 2004;19:714.
30. Perrot S, Aslangul E, Szwebel T, Caillat-Vigneron N, Le Jeunne c. Bone pain due to fractures revealing osteomalacia related to tenofovir- induced proximal renal tubular dysfunction in a human immunodeficiency virus-infected patient. J Clin Rheumatol 2009;15:72.
31. Pedrazzoni M, Vescovi PP, Maninetti L, Michelini M, Zaniboni G, Pioli GP, et al. Effects of chronic heroin abuse on bone and mineral metabolism. Acta Endocrinol (Copenh) 1993; 129:42.
32. Aukrust P, Haug CJ, Ueland T, Lien E, Muller F, Espevik T, et al. Decreased bone formative and enhanced resorptive markers in human immunodeficiency virus infection: indication of normalization of the bone-remodeling process during highly active antiretroviral therapy. J Clin Endocrinol Metab 1999;84:145.
33. Heilman P, Albert J, Gidlund M, Klareskog L, Rastad J, AkerstrOm G, et al. Impaired parathyroid hormone release in human immunodeficiency virus infection. AIDS Res Hum Retroviruses 1994;10:391.
34. McComsey GA, Tebas P, Shane E, Yin MT, Overton ET, Huang JS, et al. Bone disease in HIV infection: a practical review and recommendations for HIV care providers. Clin Infect Dis 2010;51:937.
35. Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 2014;58:1.
36. Garcia-AparicioAM, Munoz Fernandez S, Gonzalez J, Arribas JR, Pena JM, Vazquez JJ, et al. Abnormalities in the bone mineral metabolism in HIV-infected patients. Clin Rheumatol 2006;25:537.
37. Van Den Bout-Van Den Beukel CJ, Fievez L, Michels M, Sweep FC, Hermus AR, Bosch ME, et al. Vitamin D deficiency among HIV type 1 - infected individuals in the Netherlands: effects of antiretroviral therapy. AIDS Res Hum Retroviruses 2008;24:1375.
38. Mondy K, Powderly WG, Claxton SA, Yarasheski KH, Royal M, Stoneman JS, et al. Alendronate, vitamin D, and calcium for the treatment of osteopenia/ osteoporosis associated with HIV in-fection. J Acquir Immune Defic Syndr 2005;38:426.
39. McComsey GA, Kendall MA, Tebas P, Swindells S, Hogg E, Alston-Smith B, et al. Alendronate with calcium and vitamin D supplementation is safe and effective for the treatment of decreased bone mineral density in HIV. AIDS 2007;21:2473.
40. Huang J, Meixner L, Fernandez S, McCutchan JA. A double-blinded, randomized controlled trial of zoledronate therapy for HIV-associated osteopenia and osteoporosis. AIDS 2009;23:51.
41. Bolland MJ, Grey AB, Home AM, Briggs SE, Thomas MG, Ellis-Pegler RB, et al. Annual zoledronate increases bone density in highly active antiretroviral therapy-treated human immunodeficiency virus-infected men: a randomized controlled trial. J Clin Endocrinol Metab 2007;92:1283.
42. Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Washington, DC: The National Academies Press; 2010.
ดาวน์โหลด
เผยแพร่แล้ว
30-09-2014
รูปแบบการอ้างอิง
1.
ฬียาพรรณ จ, พีรกุล ย, สิทธิบุศย์ ช. โรคกระดูกพรุนในผู้ป่วยติดเชื้อเอชไอวี. Dis Control J [อินเทอร์เน็ต]. 30 กันยายน 2014 [อ้างถึง 2 มกราคม 2026];40(3):215-21. available at: https://he01.tci-thaijo.org/index.php/DCJ/article/view/154185
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ประเภทบทความ
บทความฟื้นวิชา
สัญญาอนุญาต
บทความที่ลงพิมพ์ในวารสารควบคุมโรค ถือว่าเป็นผลงานทางวิชาการหรือการวิจัย และวิเคราะห์ตลอดจนเป็นความเห็นส่วนตัวของผู้เขียน ไม่ใช่ความเห็นของกรมควบคุมโรค ประเทศไทย หรือกองบรรณาธิการแต่ประการใด ผู้เขียนจำต้องรับผิดชอบต่อบทความของตน
