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Studies have linked decreases in bone-mineral density (BMD) to both treated and untreated HIV infection. Now, a substudy of ACTG 5202 provides a close-up into the association between specific antiretrovirals and decreased BMD early in treatment.
Treatment-naive patients were randomized to one of four thymidine-sparing regimens: abacavir/3TC or tenofovir/FTC, combined with either efavirenz or ritonavir-boosted atazanavir (N Engl J Med 2009; 361:2230). The 269 patients in the substudy (85% men, 47% white non-Hispanic) underwent dual energy x-ray absorptiometry scans of the hip and lumbar spine at study entry and at five additional timepoints through week 192.
By week 96, all regimens had led to a significant decrease in hip BMD, and all but aba…