Brief Report: Changes in Plasma RANKL-Osteoprotegerin in a Prospective, Randomized Clinical Trial of Initial Antiviral Therapy. (1st July 2018)

• Record Type: Journal Article
• Authors: Kelesidis, Theodoros; Moser, Carlee B.; Johnston, Elizabeth; Stein, James H.; Dube, Michael P.; Yang, Otto O.; McComsey, Grace A.; Currier, Judith S.; Brown, Todd T.
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 78:Number 3(2018)
• Publication Date: 2018-07-01
• Subjects: HIV -- RANKL -- OPG -- CVD -- bone disease; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000001679
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: The contributions of the receptor activator of nuclear factor kappa-B ligand (RANKL)/osteoprotegerin (OPG) axis to cardiovascular and bone disease in treated HIV-1 infection are not well defined. Setting: Prospective, observational, longitudinal study. Methods: In a subset analysis of a prospective randomized clinical trial, 234 HIV-1–infected antiretroviral therapy–naive participants received tenofovir–emtricitabine plus either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir and achieved plasma HIV-1 RNA <50 copies per milliliter by week 24 and thereafter. Associations between plasma RANKL, OPG, or RANKL/OPG ratio levels with total, hip, and spine bone mineral density (BMD) loss or progression of carotid artery intima-media thickness were assessed longitudinally over 96 weeks. Results: Over 96 weeks, all treatment groups had similar and sustained declines in plasma RANKL, increases in plasma OPG, and subsequently, decreases in the RANKL/OPG ratio. There were no associations between plasma RANKL or RANKL/OPG ratio levels with total, hip, and spine BMD loss or progression of carotid artery intima-media thickness; however, plasma OPG in successfully treated HIV-infected patients (week 48 and 96) was associated with spine BMD loss. Conclusions: In virologically suppressed HIV-infected patients, the evolution of bone disease could be linked to plasma OPG levels; however, the role of plasma levels of RANKL and RANKL/OPG ratio in the prediction of morbidity in treated HIV-1 infection may be limited. Abstract : Supplemental Digital Content is Available in the Text.