NEW YORK (Reuters Health) – A single annual injection of the bisphosphonate zoledronate effectively treats HIV-associated bone loss and is generally well tolerated, a study confirms.

In HIV-infected patients, the reported prevalence of osteopenia and osteoporosis associated with highly active antiretroviral therapy (HAART) ranges from 51 to 67%, note Dr. Jeannie Huang and colleagues at the University of California, San Diego in the January 2 issue of AIDS.

In a double-blind study, 30 HIV-infected men and women with osteopenia and osteoporosis were randomly assigned to a single 5-mg intravenous dose of zoledronate or placebo. They were followed for 12 months on daily calcium and vitamin D supplements.

At entry, median T-scores were -1.7 at the lumbar spine and -1.4 at the hip. The subjects’ median CD4 cell count was 461 cells per uL, 93% had HIV viral loads less than 400 copies/ml, and 97% were taking antiretroviral medications.

At 12 months, absolute measurements of bone density as well as sex-adjusted T-scores were significantly improved in zoledronate recipients but not in the placebo group, according to the authors. Furthermore, they report, “Bone resorption markers significantly decreased during follow up in the zoledronate group as compared with the placebo group.”

No acute infusion-related reactions were seen. One patient developed uveitis, a known complication of zoledronate, which responded to medical treatment, the investigators report.

Dr. Huang and colleagues conclude that the “combination of good tolerability, low medication burden, and effectiveness” make annual zoledronate infusion an excellent approach for treating bone loss associated with chronic HAART therapy.

Reference:
AIDS 2009;23:51-57.