Changes in plasma RANKL-osteoprotegerin in a prospective, randomized clinical trial of initial antiviral therapy: A5260s

Theodoros Kelesidis, Carlee B. Moser, Elizabeth Johnston, James H. Stein, Michael P. Dube, Otto O. Yang, Grace A. McComsey, Judith S. Currier, Todd T. Brown

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)362-366
Number of pages5
JournalJournal of acquired immune deficiency syndromes
Volume78
Issue number3
DOIs
StatePublished - 2018
Externally publishedYes

Keywords

  • Bone disease
  • CVD
  • HIV
  • OPG
  • RANKL

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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