Bone turnover markers in children living with HIV remaining on ritonavir-boosted lopinavir or switching to efavirenz.
Bone
Bone turnover markers
Osteocalcin
Protease inhibitors
Journal
Bone
ISSN: 1873-2763
Titre abrégé: Bone
Pays: United States
ID NLM: 8504048
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
14
02
2020
revised:
15
05
2020
accepted:
14
06
2020
pubmed:
27
6
2020
medline:
22
6
2021
entrez:
27
6
2020
Statut:
ppublish
Résumé
We previously found lower bone mass but similar bone turnover in pre-pubertal children living with HIV (CLWH) on a ritonavir-boosted lopinavir (LPV/r)-based vs. efavirenz-based antiretroviral therapy regimen 2 years after switch. Here, we evaluate if bone turnover differed between the groups close to the time of switch. Samples from 108 children remaining on LPV/r and 104 children switched to efavirenz were available for analysis 8 weeks post-randomization. Bone turnover markers, including C-telopeptide of type 1 collagen (CTx), procollagen type-I N-terminal propeptide (P1NP), and osteocalcin were measured. Markers of immune activation were also measured, including IL-6, TNF-alpha, soluble CD14 and high-sensitivity C-reactive protein (CRP). Eight weeks post-randomization, we did not detect differences in CTx (1.42 vs. 1.44 ng/mL, p = 0.85) or P1NP concentrations (622 vs. 513 ng/mL, p = 0.68) between treatment groups. At 8 weeks, the treatment groups also had similar levels of IL-6, TNF-alpha, soluble CD14 and high-sensitivity CRP. Osteocalcin (ng/mL) was higher in the LPV/r than efavirenz group both at 8 weeks (88.6 vs. 67.3, p = 0.001) and 2 years (67.6 vs. 49.8, p = 0.001). Overall, we failed to detect difference in bone turnover by P1NP and CTx in virologically-suppressed CLWH on different regimens at a time point close to the switch. We did observe higher levels of total osteocalcin in children remaining on LPV/r compared to children switched to efavirenz. Future studies should focus on uncovering the mechanism and determining whether perturbation in undercarboxylated osteocalcin could explain some of the bone side effects noted with protease inhibitors.
Identifiants
pubmed: 32590137
pii: S8756-3282(20)30280-5
doi: 10.1016/j.bone.2020.115500
pmc: PMC8786259
mid: NIHMS1624041
pii:
doi:
Substances chimiques
Alkynes
0
Benzoxazines
0
Cyclopropanes
0
Lopinavir
2494G1JF75
efavirenz
JE6H2O27P8
Ritonavir
O3J8G9O825
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
115500Subventions
Organisme : NICHD NIH HHS
ID : R01 HD061255
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD073952
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD073977
Pays : United States
Informations de copyright
Copyright © 2020. Published by Elsevier Inc.
Déclaration de conflit d'intérêts
Declaration of competing interest Stephanie Shiau, Michael T. Yin, Renate Strehlau, Jing Shen, Elaine J. Abrams, Ashraf Coovadia, Louise Kuhn, and Stephen M. Arpadi declare that they have no conflict of interest.
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