Background: Worldwide and Uganda specifically there is limited data on magnitude and risk factors of bone loss among HIV infected adults. Multiple factors seem to contribute to the burden of bone loss in HIV infected adults. These may include age, antiretroviral therapy, and nutrition among others. The objective of the study was to determine prevalence and risk factors of bone loss in HIV infected adults attending an HIV care clinic at MUJHU research collaboration clinic.
Methods: A cross- sectional study was conducted among HIV positive 18-64 years old eligible patients during their routine clinic visit days from July 2012 to March 2013 after ethical clearance. Data was collected using a pretested questionnaire capturing both primary and secondary data (from patients medical records). 6 mls of blood were drawn for CD4, serum Calcium and Phosphate levels. Dual Energy X-ray Absorptiometry (DEXA) scan for both the lumber and proximal femur (hip) were done to assess the Bone mineral density to establish bone loss. Pearson correlation coefficient and regression for the CD4, odds ratio and p-value was computed to assess association.
Results: 326 patients visited the HAART clinic during the study period and we enrolled 78 participants. Some of the reasons for exclusion include refusal to consent due to fear of effects of radiations (n=145), pregnancy (n=82). 15 out of the 78 respondents had reduced bone mineral density giving a prevalence of 19.23%. Low CD4 was found to be negatively associated with bone loss (r = -0.675). Several factors including Age Odd Ratio (OR) = 3.75, P = 0.0025; HAART OR = 2.96, P = 0.004; Body Mass Index, OR = 5.68, P = 0.001; and contraceptive use in the female patients OR = 1.42, P = 0.021; were found to be significant positively associated with bone loss among HIV positive adults. Women were more at risk of bone loss than their male counterparts. 44% had abnormal level of serum calcium and 60% of patients with osteoporosis had low serum calcium levels. 28% overall had low serum phosphate levels and 60% with osteoporosis had low serum level.
Conclusion: Bone loss was common among HIV positive patients on HAART, Hormonal Contraceptives use in the female, have low CD4 cell count and low body mass index. Low levels of serum calcium and phosphate was prevalent among HAART patients