Risk factors of osteopenia in HIV-infected women: no role of antiretroviral therapy.

OBJECTIVES: Osteopenia and osteoporosis are more frequent in HIV-infected patients. Whether antiretroviral therapy induces a bone mineral density (BMD) loss remains controversial and few data are available in women. This cross-sectional study of 89 pre-menopausal HIV-infected women evaluates the relationship between BMD and antiretroviral treatment. METHODS: Three groups of women were compared: women never treated (n=37), women treated with nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors and never treated with protease inhibitor (PI) (n=25) and women treated with a PI-containing regimen (n=27). Their lumbar spine and hip BMD was measured by dual-energy X-ray absorptiometry. We assessed also demographic parameters, body mass index (BMI), habits, history of HIV infection and treatment, lipodystrophy and metabolic and hormonal parameters. RESULTS: 83% were African women. Mean age was 37 years. Median duration of HIV treatment was 3.5 years. The overall prevalence of osteopenia/porosis was 31.5%. No difference was found between the three groups. Using logistic regression, low BMI was the only factor associated with osteopenia/porosis. CONCLUSION: Osteopenia/porosis was highly prevalent among these HIV-infected pre-menopausal women, mainly of African origin. BMD loss was not associated with antiretroviral therapy (containing PI or not) but was associated with a low BMI.

Engrafting periodontal fibroblasts with new 3-dimensional polylactide foams.

In clinical periodontics, "tissue engineering" techniques have been developed to guide the regenerative process following periodontal disease. We explored a new shaped biomaterial in order to promote cellular adhesion, proliferation and migration of periodontal cells. Granules of poly-D, L-lactide were foamed in specially designed moulds by a controlled gas-loading process. Explant cultures of periodontal tissue were seeded at different densities on the 3-dimensional scaffolds following analysis of cytotoxicity, cell proliferation and differentiation. The moulding procedure led to porous structures with predetermined tubes for cellular locomotion. Cells adhered to and populated the material's surface and inner cavities while retaining fibroblastic phenotype. An optimal ratio between cellular proliferation and mortality rate was achieved at a seeding density of > 10 6 cells/cm 3 scaffold. We designed modified polylactide scaffolds capable of acting as a stent and a cell carrier matrix. The foaming process is easy, cheap and suitable for commercial production.

Indinavir/ritonavir-based therapy in HIV-1-infected antiretroviral therapy-naive patients: comparison of 800/100 mg and 400/100 mg twice daily.

Objectives To compare the efficacy and tolerability of indinavir (IDV)/ritonavir (RTV) at 800/100 and 400/100 mg twice daily (bid) in antiretroviral therapy (ART)-naive patients. Methods An open comparison of two groups of ART-naive patients treated with IDV/RTV 800/100 or 400/100 mg bid plus two nucleoside analogues was carried out. Viral load, CD4 cell count and tolerability were measured at baseline and at weeks 4, 12, 24 and 48. IDV plasma concentrations were measured retrospectively. Results A total of 107 patients were included in the study. Of these, 57 were treated with 800/100 and 50 with 400/100 mg IDV/RTV bid. At week 48, a viral load of <50 HIV-1 RNA copies/mL was achieved by 77 and 64% of the patients, respectively, and the median CD4 cell count increases were +171 and +164 cells/muL (intent-to-treat; P not significant), respectively. Side effects leading to protease inhibitor discontinuation occurred in 61% of subjects in the 800/100 mg group vs. 20% in the 400/100 mg group (P<0.0001). Switching from 800/100 to 400/100 mg dosage improved adverse events in 16 of 20 patients. IDV concentrations were above 0.15 mg/L in 89% of the 28 patients tested in the 400/100 mg group. Conclusions Indinavir/ritonavir 400/100 mg bid provided the same efficacy as 800/100 mg bid at 48 weeks in an ART-naive population, but safety and tolerance were significantly better for 400/100 mg, while convenience was also improved and cost was reduced.