Prevalence and associated factors of osteoporosis in HIV infected adults attending MU-JHU outpatient clinic at Mulago National Referral Hospital.

Abstract

Introduction Western studies have described and noted an increased prevalence rate of osteoporosis in HIV infected patients. The causes of osteoporosis in this population appear to be multifactorial and likely represent a complex interaction between HIV infection, traditional osteoporosis risk factors, and antiretroviral-related factors. Methodology This was a cross-section and descriptive study conducted between July 2012 and March 2013. The study determined the prevalence of osteoporosis, established its relationship with CD4 cell count and identified other factors associated with osteoporosis in HIV infected adults attending MU-JHU clinic in Mulago National Referral Hospital. Data was collected using a pretested questionnaire and both primary and secondary data was used. Osteoporosis was determined by use of the Dexa Scan while CD4, Phosphate and Calcium serum level was based on the laboratory results of the blood samples from 78 patients. Data analysis was done by the assistance of a statistician using the Pearson correlation coefficient and regression for the CD4, and odds ratio and p-value for the associated factors. Results 15 out of the 78 respondents had osteoporosis giving a prevalence of 19.23%. Low CD4 was found to be negatively associated with osteoporosis (r = -0.675). Several factor including Age Odd Ratio (OR) = 3.75,P = 0.0025; BMI, OR = 5.68, P = 0.001; HAART OR = 2.96, P = 0.004 and contraceptive use in the female patients OR = 1.42, P = 0.021; were found to be significant positively associated with osteoporosis among HIV positive adults.

Conclusion and Recommendation The results of the study suggest that osteoporosis is fairly common among HIV positive patients especially those on HAART, Hormonal Contraceptives use in the female, those with low CD4 cell count and low BMI increased the risk of osteoporosis. It was recommended that patients with HIV especially those with significant risk factors mentioned above should routinely be screened for osteoporosis.