Dietary Calcium Intake and Bone Mineral Density in HIV and Hepatitis C Patients
Overview
This study evaluated the relationship between dietary calcium intake and bone mineral density (BMD) among men with HIV, hepatitis C virus (HCV), HIV/HCV coinfection, and uninfected controls. While osteoporosis and osteopenia were common across groups, only HCV-monoinfected patients with osteoporosis showed significantly lower calcium intake compared to those with normal BMD.
Background
Reduced bone mineral density is prevalent in individuals infected with HIV, HCV, or both, contributing to increased fracture risk. Multiple factors including viral infection, inflammation, antiretroviral therapy, and liver dysfunction may influence bone health. Nutritional deficiencies such as inadequate calcium intake are modifiable risk factors that may impact BMD. Despite known associations, limited data exist on calcium intake and its correlation with BMD in these populations.
Data Highlights
Infection Group
Calcium Intake (mg/d)
BMD Status
Significance
HCV Monoinfection
Lower in osteoporosis group by 409 mg/d (95% CI, 35–784 mg/d)
Osteoporosis vs Normal BMD
P = .03
HIV Monoinfection
No significant difference
Osteoporosis vs Normal BMD
NS
HIV/HCV Coinfection
No significant difference
Osteoporosis vs Normal BMD
NS
Controls
No significant difference
Osteoporosis vs Normal BMD
NS
Key Findings
Osteoporosis and osteopenia were prevalent among all infection groups and controls.
No overall association was found between infection status and BMD results (χ2(6) = 6.813; P = .34).
Only HCV-monoinfected patients with osteoporosis had significantly lower dietary calcium intake compared to those with normal BMD.
Calcium intake was assessed using a validated dietary questionnaire and adjusted for confounders including age, race, BMI, and smoking.
HIV and HIV/HCV coinfected patients did not show a correlation between calcium intake and BMD.
Clinical Implications
Clinicians should recognize the high prevalence of reduced BMD in patients with HIV and/or HCV infection and consider assessing dietary calcium intake, especially in those with HCV monoinfection. Nutritional counseling to optimize calcium intake may be particularly beneficial in HCV-infected patients with osteoporosis. Routine BMD screening remains important given the multifactorial risk of bone loss in these populations.
Conclusion
Dietary calcium intake correlates with bone mineral density reduction only in patients with HCV monoinfection, highlighting the need for targeted nutritional interventions in this subgroup. Overall, infection status alone does not predict BMD abnormalities, underscoring the multifactorial nature of bone health in these patients.
References
Brown 2010 -- Low Bone Mineral Density in HIV and HCV Infection
Maalouf et al 2007 -- Osteopenia in Early Hepatitis C
Bedimo et al 2011 -- Risk Factors for Reduced BMD in HIV
