Evaluation of serum phosphorus levels and their relation with the development of osteoporosis in people living with HIV/AIDS

评估艾滋病毒/艾滋病感染者血清磷水平及其与骨质疏松症发生发展的关系

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Abstract

OBJECTIVE: The aim of this study was to assess the relationship between hypophosphatemia and osteoporosis in people living with HIV on antiretroviral therapy, and to identify risk factors associated with both conditions. METHODS: This was a cross-sectional, analytical study of 96 patients at a clinic in Belém-PA. Data collection included serum phosphorus, calcium, vitamin D, parathyroid hormone, renal parameters, and bone mineral density (T-score). Student's t-test, Mann-Whitney U test, chi-square test, or Fisher's exact test was applied, as well as multiple logistic regression for hypophosphatemia and osteoporosis. RESULTS: Of the 96 patients, 24 (25%) had hypophosphatemia, with a male predominance (75%). There was a statistically significant association (p<0.05) between hypophosphatemia and longer duration of infection and use of antiretroviral therapy, as well as a higher prevalence in men. Regimens containing tenofovir disoproxil fumarate showed an increased risk of hypophosphatemia, although logistic regression did not confirm significance at the 5% level. As for osteoporosis, there was an association with female gender and age but no direct relationship with hypophosphatemia. CONCLUSION: Hypophosphatemia was significantly associated with male gender, prolonged infection, and the use of antiretroviral therapy, especially regimens with tenofovir disoproxil fumarate. There was no statistical correlation between hypophosphatemia and osteoporosis, but female gender and advanced age were risk factors for the latter. These findings highlight the importance of monitoring bone and kidney parameters in people living with HIV, especially those on long-term tenofovir disoproxil fumarate, with a view to more effective preventive and therapeutic strategies.

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