{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T17:33:28Z","timestamp":1763141608275,"version":"3.40.5"},"reference-count":47,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T00:00:00Z","timestamp":1626134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Treatment with bisphosphonates and discontinuation of tenofovir disoproxil fumarate (TDF) are recommended strategies for managing osteoporosis in people living with HIV (PLHIV). This study aimed to compare the effects on bone mineral density (BMD) of TDF discontinuation with and without bisphosphonate therapy in osteoporotic PLHIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present study is a retrospective cohort analysis of dual\u2010energy X\u2010ray absorptiometry scan results of PLHIV attending Chelsea and Westminster Hospital HIV clinic between 2009 and 2020. Osteoporotic (T\u2010score\u00a0&lt;\u00a0\u22122.5) patients with \u2265\u00a06\u00a0months\u2019 TDF exposure were included. Changes in BMD and T\u2010scores at the lumbar spine (LS) and femoral neck (FN) were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 84 participants were included, of whom 43 discontinued TDF only (TS) and 41 switched from TDF and received bisphosphonates (TS+): 86.9% were male; 77.4% were white; median (interquartile range, IQR) age was 54.8 (51.0\u201358.5) years; and median (IQR) TDF exposure was 6.5\u00a0(3.5\u201310.4) years. At a median follow\u2010up of 2\u00a0years after TDF\u2010discontinuation, mean spine BMD increased significantly in both groups, but bisphosphonate recipients had greater improvements (4.83% <jats:italic>vs<\/jats:italic>. 7.79%; <jats:italic>P\u00a0&lt;<\/jats:italic>\u00a00.019); LS T\u2010scores improved significantly but changes were comparable between groups (TS, 0.5 <jats:italic>vs<\/jats:italic>. TS+, 0.6; <jats:italic>P\u00a0=<\/jats:italic>\u00a00.270). At the FN, no significant increases in BMD were observed (TS, 3.05% <jats:italic>vs<\/jats:italic>. TS+, 2.71%; <jats:italic>P\u00a0=<\/jats:italic>\u00a00.205); T\u2010scores significantly improved in bisphosphonate recipients only (+0.2; <jats:italic>P\u00a0=<\/jats:italic>\u00a00.003). A greater proportion recovered from osteoporosis in the TS+ group (34.9% <jats:italic>vs<\/jats:italic>. 43.9%), although differences between groups were not significant (<jats:italic>P\u00a0=<\/jats:italic>\u00a00.503).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our real\u2010world data indicate that although TDF discontinuation significantly improved bone health in osteoporotic PLHIV, combining bisphosphonates with TDF discontinuation resulted in greater improvements in BMD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13137","type":"journal-article","created":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T01:00:12Z","timestamp":1626224412000},"page":"816-823","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The benefits of tenofovir discontinuation with or without bisphosphonate therapy in osteoporotic people living with HIV"],"prefix":"10.1111","volume":"22","author":[{"given":"Jonathan Jin Hei","family":"Lei","sequence":"first","affiliation":[{"name":"Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9512-8442","authenticated-orcid":false,"given":"Branca","family":"Pereira","sequence":"additional","affiliation":[{"name":"Imperial College London London UK"},{"name":"HIV\/GUM Directorate Chelsea and Westminster Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graeme","family":"Moyle","sequence":"additional","affiliation":[{"name":"HIV\/GUM Directorate Chelsea and Westminster Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Boffito","sequence":"additional","affiliation":[{"name":"Imperial College London London UK"},{"name":"HIV\/GUM Directorate Chelsea and Westminster Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7732-9168","authenticated-orcid":false,"given":"Ana","family":"Milinkovic","sequence":"additional","affiliation":[{"name":"HIV\/GUM Directorate Chelsea and Westminster Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506816"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000298"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000243"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30155-8"},{"volume-title":"HIV in the United Kingdom\u202f: Towards Zero HIV transmissions by 2030 (2019 Report)","year":"2019","author":"Public Health 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