The BONDY Study
Research type
Research Study
Full title
The BONDY Study: Bone Density in Youth living with perinatally acquired HIV
IRAS ID
246353
Contact name
Caroline Foster
Contact email
Sponsor organisation
Imperial College Healthcare NHS Trust
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
Summary of Research
Peak bone mass is reached around 25 years of age and low peak bone mass is associated with osteoporosis later in life. Low bone mineral density (BMD) is reported in adolescents living with perinatally acquired HIV infection (PaHIV) however there is no data on longer term outcomes after 25 years of age. Antiretroviral therapy (ART) used to treat HIV is associated with reduced bone mineral density and this is most apparent in regimens that include tenofovir. This study assesses the bone health of 2 groups of young people born with HIV and compares their bone density to the general aged matched population.
1. Aged 25 years and older (n=30) post peak bone mass
2. Aged 15-24 years
Those aged 15-24 years will have their bone health assessed 12 months later to look at the accrual of bone mass during that time.
Bone health is assessed by bone density scanning and blood and urine samples looking at markers of bone turnover and levels of vitamins and minerals important for bone health.Summary of Results
The BONDY study looked at bone and metabolic health in young people living with HIV acquired from birth. 130 young people were recruited for the baseline visit; 50 age 15-19 years, 50 aged 20-24 years and 30 age 25 years and older. During the baseline visit young people gave informed consent and had a bone density scan (DEXA) and gave blood and urine samples that were then analysed for markers of bone health. This data was presented at the British HIV association conference in 2020 and showed that overall 46% had evidence of low done density (termed osteopenia/osteoporosis) and 85% had low blood levels for vitamin D. Bone health was generally poorer in those aged 25 and older, the age by which peak bone mass accrual has occurred. Other factors associated with poorer bone health were current vitamin D deficiency, impaired mobility, alcohol use and body mass index. All participants recieved feedback of their results with vitamin D supplementation, dietary advice and referral to endocrinology as clinically indicated. The 100 participants aged under 25 years, prior to peak bone mass accrual were followed to look at how well they accrued bone mineral denisty overtime. A second bone scan was performed, initially this was meant to be after 12 months but because of COVID was delayed until an average of 26 months. At this visit participants were also asked if they would like to take part in a metabolic substudy where in addition to the baseline visit investigations metabolic analyses including fasting lipids and glucose, fat distribution ( total body DEXA) and liver fat by ultrasound (Fibroscan) were performed. 85 young people took part in visit 2 and the metabolic substudy the results of which are going presented at the Conference on Retroviruses and Opportunistic Infections (CROI2023) next week. In essence young people living with HIV gained bone mineral density at the same rate as the general population when matched for age, sex and ethnicity. More than half had a body mass index >25 ie overweight/obese and more than 50% had one or more adverse marker of metabolic health ( including blood pressure, fasting lipids and glucose and waist circumference). Poor metabolic health also impacted on bone health but did not seem to be related to the type of antiretroviral therapy taken. To improve both bone and metabolic health for young people living with HIV we need to concentrate on modifying traditional risk factors.
REC name
London - Stanmore Research Ethics Committee
REC reference
18/LO/1474
Date of REC Opinion
12 Oct 2018
REC opinion
Further Information Favourable Opinion