{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:02:19Z","timestamp":1773396139063,"version":"3.50.1"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"1","funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["AR059364"],"award-info":[{"award-number":["AR059364"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["AR070091"],"award-info":[{"award-number":["AR070091"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fractures are common in people with HIV (PWH). Interleukin 4 (IL-4), an antiosteoclastogenic product of CD4 Th2 T cells, becomes depleted in PWH; however, its role in skeletal deterioration in PWH is unknown. We therefore examined associations between IL-4 and bone mineral density (BMD), bone resorption and formation markers (\u03b2-C-terminal telopeptide of type I collagen and osteocalcin), and the osteoclastogenic regulators receptor activator of NF-\u03baB ligand (RANKL) and osteoprotegerin in PWH who were antiretroviral therapy (ART) naive and people without HIV (PWoH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Commercial enzyme-linked immunosorbent assays were used to measure factors in a cohort of 37 ART-naive PWH and 28 PWoH and in an independent cohort of 29 ART-experienced PWH. BMD was quantified by bone densitometry, and IL-4 associations were analyzed by sex and HIV status via Spearman correlation and multivariable linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>IL-4 was significantly lower in ART-naive PWH as compared with PWoH and higher in ART-experienced PWH vs ART-naive PWH. With ART-naive PWH and PWoH combined, IL-4 correlated inversely with \u03b2-C-terminal telopeptide of type I collagen, RANKL, and RANKL\/osteoprotegerin ratio in males and females, individually and when aggregated, but not in ART-naive PWH or PWoH individually. In PWoH and ART-naive PWH combined, IL-4 was significantly associated with higher lumbar spine Z score and most femoral BMD T and Z scores in males but not females.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IL-4 levels are reduced in treatment-naive PWH and higher in ART-experienced PWH. IL-4 positively correlates with BMD in men but not women, suggesting that IL-4 protects the male skeleton and that IL-4 decline may contribute to bone loss in men with HIV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf570","type":"journal-article","created":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T12:48:28Z","timestamp":1765111708000},"page":"e221-e229","source":"Crossref","is-referenced-by-count":0,"title":["IL-4 Correlates With Bone Mineral Density in Men, and IL-4 Depletion May Drive Bone Loss in Men With HIV"],"prefix":"10.1093","volume":"233","author":[{"given":"Ighovwerha","family":"Ofotokun","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University"},{"name":"Ponce De Leon Center, Grady Healthcare System"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kehmia","family":"Titanji","sequence":"additional","affiliation":[{"name":"Division of 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