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ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Bone loss on TVD prep
Presentation by Andrew Carr.
Bone loss in 1st year of ART is a well established fact.
Loss is more on tenofovir containing regimes 2.4-3.8% non tenofovir 0.7-2.5%.
Compare to 1 year 10mg prednisolone 0.8 -3% loss
4RTC's show 0.5-1.5% loss BMD over 12-30 months!
Reversible if stopped after 1 year
Reversibility not established for longer periods, prep may be long term
Proportion of those with greater bone is uncertain
>3% loss at hip and LSS in 25-50%
Non adherence issues in early RCTs , so bone loss may be underestimated.
Study 36 men taking TDF-FTC PrEP on prelude trialNSW,av age 38, av weight 79.9,TDF exposure pretrial 6months.
Average BMD loss - 2.2 spine,-2.5 fem neck,but,approx 45% lost>3%, 25% lost>5% BMD
Study limitations :no control,no women,some loss attribuible to age, 1 year data only,no PK data
Longer f/up, data on secondary causes of BMD loss,more patients to identify risks for the greater loss group