INTRODUCTION Use of tenofovir based anti-retroviral therapy (ART) in HIV patients is associated with low bone mineral density (BMD). Low BMD predisposes people living with HIV (PLWHIV) to fractures thereby increasing morbidity and mortality. Since the introduction of tenofovir based ARV regimens in 2011, information on the prevalence of low BMD in PLWHIV and receiving ART is still scarce in Malawi. This study aimed to determine the prevalence and associated factors of low BMD among adults living with HIV and receiving ART in Blantyre, Malawi. METHODOLOGY This was a cross sectional study involving 282 HIV-positive adults of whom 102 (36%) were males. The participants aged 18-45 years were recruited from three primary and one tertiary health care facilities. Patients with no other comorbidities or conditions associated with low BMD and on ART >12 months were included. Data on BMD (femoral neck and lumbar spine) were collected using Dual-Energy X-ray Absorptiometry (DEXA). The International Physical Activity Questionnaire (IPAQ) was used to assess the physical activity (PA) levels. Participants' body weight (kg) and height (m) were also measured. Descriptive statistics, Chi-Square test and multivariable logistic regression were used to analyse data. RESULTS Mean age of participants was 37(± 6.4) years, mean duration on ART was 5(± 3.5) years and mean body mass index (BMI) was 23(± 4.5) kg/m2. Twenty percent (55) had reduced BMD. More males (28%) had reduced BMD than females (14%) (p = 0.04). There was a significant association between lumbar BMD and femoral neck BMD (r = 0.66,p<0.001). However, on average, lumbar BMD (g/cm2) was significantly lower than the femoral BMD (p < 0.001). Participants with low PA level (OR 1.23,p = 0.6) had higher odds of having reduced BMD compared to those with high PA level. CONCLUSIONS AND RECOMMENDATION Prevalence of reduced BMD is high among PLWHIV in Malawi especially male Malawian adults. Occurrence of low BMD is associated with low PA level. There is need for health care providers to routinely monitor BMD and PA levels of this population.

中文翻译：

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马拉维布兰太尔接受抗逆转录病毒治疗的艾滋病毒感染患者骨矿物质密度降低：患病率和相关因素。

简介 在 HIV 患者中使用基于替诺福韦的抗逆转录病毒治疗 (ART) 与低骨矿物质密度 (BMD) 相关。低 BMD 使艾滋病毒感染者 (PLWHIV) 容易骨折，从而增加发病率和死亡率。自 2011 年引入基于替诺福韦的抗逆转录病毒治疗方案以来，马拉维关于艾滋病毒感染者和艾滋病毒感染者低骨密度患病率以及接受抗逆转录病毒治疗的信息仍然很少。本研究旨在确定马拉维布兰太尔艾滋病毒感染者和接受抗逆转录病毒疗法的成年人中低骨密度的患病率和相关因素。方法 这是一项横断面研究，涉及 282 名 HIV 阳性成年人，其中 102 名 (36%) 为男性。年龄在 18-45 岁之间的参与者是从三个初级卫生保健机构和一个三级卫生保健机构中招募的。没有其他合并症或与低 BMD 相关的病症并且接受 ART > 12 个月的患者被纳入。使用双能 X 射线吸收测定法 (DEXA) 收集 BMD（股骨颈和腰椎）数据。国际体力活动问卷（IPAQ）用于评估体力活动（PA）水平。还测量了参与者的体重（公斤）和身高（米）。使用描述性统计、卡方检验和多变量逻辑回归来分析数据。结果 参与者的平均年龄为 37(± 6.4) 岁，平均接受 ART 的时间为 5(± 3.5) 年，平均体重指数 (BMI) 为 23(± 4.5) kg/m2。百分之二十 (55) 的 BMD 有所降低。骨密度降低的男性 (28%) 多于女性 (14%) (p = 0.04)。腰椎 BMD 和股骨颈 BMD 之间存在显着相关性（r = 0.66，p<0.001）。然而，平均而言，腰椎 BMD (g/cm2) 显着低于股骨 BMD (p < 0.001)。与 PA 水平高的参与者相比，PA 水平低的参与者 (OR 1.23，p = 0.6) 骨密度降低的几率更高。结论和建议 马拉维艾滋病毒感染者尤其是马拉维男性成年人中 BMD 降低的患病率很高。低 BMD 的发生与低 PA 水平有关。医疗保健提供者需要定期监测该人群的 BMD 和 PA 水平。