{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T07:19:23Z","timestamp":1777619963973,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2015,2,25]],"date-time":"2015-02-25T00:00:00Z","timestamp":1424822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01-AI068641"],"award-info":[{"award-number":["U01-AI068641"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1-AI068641"],"award-info":[{"award-number":["UM1-AI068641"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2015,4]]},"abstract":"Objectives<\/jats:title>HIV<\/jats:styled-content> infection is associated with a higher prevalence of low bone mineral density (BMD<\/jats:styled-content>) and fractures than that found in the general population. There are limited data in HIV<\/jats:styled-content>\u2010positive adults, na\u00efve to antiretroviral therapy (ART<\/jats:styled-content>), with which to estimate the relative contribution of untreated HIV<\/jats:styled-content> infection to bone loss.<\/jats:p><\/jats:sec>Methods<\/jats:title>The primary objective of the Strategic Timing of AntiRetroviral Treatment (START<\/jats:styled-content>) Bone Mineral Density Substudy is to compare the effect of immediate versus deferred initial ART<\/jats:styled-content> on bone. We evaluated traditional, demographic, HIV<\/jats:styled-content>\u2010related and immunological factors for their associations with baseline hip and lumbar spine BMD<\/jats:styled-content>, measured by dual\u2010energy X<\/jats:styled-content>\u2010ray absorptiometry, using multiple regression.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 424 ART<\/jats:styled-content>\u2010na\u00efve participants were enrolled at 33 sites on six continents; the mean age was 34 years [standard deviation (SD<\/jats:styled-content>) 10.1 years], 79.0% were nonwhite, 26.0% were women, and 12.5% had a body mass index (BMI<\/jats:styled-content>)\u2009<\u200920\u2009kg\/m2<\/jats:sup>. Mean (SD<\/jats:styled-content>) Z<\/jats:styled-content>\u2010scores were \u22120.41 (0.94) at the spine and \u22120.36 (0.88) for total hip; 1.9% had osteoporosis and 35.1% had low BMD<\/jats:styled-content> (hip or spine T<\/jats:styled-content>\u2010score\u2009<\u2009\u22121.0). Factors independently associated with lower BMD<\/jats:styled-content> at the hip and spine were female sex, Latino\/Hispanic ethnicity, lower BMI<\/jats:styled-content> and higher estimated glomerular filtration rate. Longer time since HIV<\/jats:styled-content> diagnosis was associated with lower hip BMD<\/jats:styled-content>. Current or nadir CD4<\/jats:styled-content> cell count and HIV<\/jats:styled-content> viral load were not associated with BMD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In this geographically and racially diverse population of ART<\/jats:styled-content>\u2010na\u00efve adults with normal CD4<\/jats:styled-content> cell counts, low BMD<\/jats:styled-content> was common, but osteoporosis was rare. Lower BMD<\/jats:styled-content> was significantly associated with traditional risk factors but not with CD4<\/jats:styled-content> cell count or viral load.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12242","type":"journal-article","created":{"date-parts":[[2015,2,25]],"date-time":"2015-02-25T09:55:37Z","timestamp":1424858137000},"page":"137-146","source":"Crossref","is-referenced-by-count":42,"title":["Prevalence of and risk factors for low bone mineral density in untreated HIV<\/scp> infection: a substudy of the INSIGHT<\/scp> Strategic Timing of AntiRetroviral Treatment (START<\/scp>) trial"],"prefix":"10.1111","volume":"16","author":[{"given":"A","family":"Carr","sequence":"first","affiliation":[{"name":"Centre for Applied Medical Research St Vincent's Hospital Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Grund","sequence":"additional","affiliation":[{"name":"School of Statistics University of Minnesota Minneapolis MN 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