The slight loss in bone mineral density associated with HIV PrEP antiretroviral use is reversible in young adult patients who stop taking the drugs, according to findings presented by Robert Grant today at the CROI in Boston.
The findings result from a bone mineral density substudy of two large clinical trials, iPrEx and iPrEx OLE.Data from the substudy presented today illustrate that bone mineral density decreased a measurable but clinically insignificant amount over the course of a year in young adult males and transgender participants with an average age of 24 taking a protective amount of PrEP. However, six months after stopping the regimen, bone mineral density levels in the spines of these individuals increased to levels consistent with study participants of the same age who took a placebo. Hip bone mineral densities also increased in the first six months after stopping PrEP and returned to normal levels by a median follow-up time of 73 weeks.
Previous studies using sensitive scans have shown that HIV medications containing tenofovir slightly reduce bone mineral density, though not to a degree at which patients experience complications. This is the first study to show that this effect is reversible when a patient can stop PrEP, such as when an individual enters into a mutually monogamous relationship with another HIV-negative individual.
Take home message: It appears that Truvada-based oral PrEP may not pose an irreversible effect on bone mineral density in young adults.