Washington Post

Tuesday, February 1, 2000

Studies Say HIV Drugs Raise Risk of Bone Loss

By David Brown

SAN FRANCISCO, Jan. 31 -- The catalogue of undesirable side effects that AIDS drugs can produce is growing, researchers reported today.

Bone loss--in some cases, severe enough to meet the definition of osteoporosis--is a newly recognized hazard of taking antiviral medicines in the protease inhibitor family, the researchers reported at the Seventh Conference on Retroviruses and Opportunistic Infections.

Those drugs are already known to cause changes in both the distribution of body fat and the bloodstream concentrations of fats such as cholesterol and triglyceride.

It's increasingly clear, however, that protease inhibitors, which are commonly used in "triple therapy" drug regimens, aren't the only problem medications. A substantial number of people taking combinations of other antivirals also show the loss of fat in the limbs and face, and its accumulation in the abdomen and between the shoulder blades, originally attributed to protease inhibitors.

Although the side effects are bothersome enough for many people with human immunodeficiency virus (HIV) infection to try non-protease-containing combinations, so far they appear to produce few life-threatening complications, researchers reported.

For example, data compiled by four drug companies conducting studies of their own protease inhibitors showed no increased rate of heart attacks over one year.

But two studies presented today described accelerated bone-mineral loss in people taking protease inhibitors. One, from Washington University in St. Louis, found that among 122 people on triple therapy, 21 percent of those taking protease inhibitors had osteoporosis. Among men, use of those drugs were associated with a two-fold risk of significant bone loss. A study of 74 patients in Australia found that 28 percent had low bone density, and 10 percent had osteoporosis.

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