Chronic Hepatitis B Infection Compromises Bone Health Despite Antiretroviral Medication, Study Finds

A recent study has revealed that chronic hepatitis B infection compromises bone health by increasing bone resorption, regardless of the use of antiretroviral drugs.

Photo: Hepatitis B Virus | InStyleHealth


Researchers did a cross-sectional examination of 81 adult patients with chronic hepatitis B infection. Dual-energy X-ray absorptiometry was used to measure bone mineral density, while biochemical analyses were also performed to quantify levels of markers such as osteocalcin, parathyroid hormone, and urinary deoxypyridinoline, among others.

Participants were divided into three groups of 27, where each, according to treatment approach. Group 1 included inactive virus carriers without medication, group 2 had patients treated with tenofovir, while those on lamivudine/entecavir medication fell under group 3. All the groups were generally comparable, with the exception of the viral load, that which was significantly increased in group 1 vs 2 and 3.

Based on DXA, osteopenia at the lumbar spine occurred more frequently in the tenofovir group as opposed to groups 1 and 3. However, bone mineral density Z scores at the lumbar spine did not differ across the three groups. Same was true for Z scores at the total hip and femoral neck.

Regarding serum and urinary markers, levels of osteocalcin and parathyroid hormone were significantly different across groups, with a tendency to be higher in group 2. Though, all values remained within the normal limits.

Remarkably, while concentrations of urinary deoxypyridinoline, a marker for bone resorption, did not differ among groups, all levels were above the normal limit, suggesting elevated resorptive activity in patient with chronic hepatitis B.

According to researchers that studies about bone metabolism and how it can be affected by factors such as chronic infections and medications continue to evolve and pose a major challenge to better understand the physiology of bone loss. Thus, further research is warranted to validate the current findings.

 

Source: Sci Rep 2021;11:10162

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