Do PIs cause–or quell–osteopenia?
Probably recalling some precipitant theories on the cause of lipodystrophy, researchers are circling warily round the question of what drives bone mineral loss in HIV-infected people. Suggestions include: • Protease inhibitors (which some say are protective) • Fat atrophy (often attributed to NRTIs) • Lactic acidosis (more often attributed to NRTIs) • HIV itself Pablo Tebas (Washington University, St. Louis) assumed the daunting task of probing for links between PIs and debarking bone minerals. Earlier he used DEXA scans to chart significantly lower bone density scores in people taking PIs than in those taking only non-PI regimens or in healthy volunteers.21 Bone density scores did not correlate with fat changes in this 112-man study. At the Lipodystrophy Workshop, Tebas stepped to the plate with two studies, one in vivo and one in vitro, one clocking fast bone turnover in people taking PIs and one suggesting PIs squelch activation of vitamin D, critical to bone health. Tebas began wit
