Efficacy And Security Of Annual And Biennial Zoledronic Acid For Osteoporosis Treatment In An HIV-Infected Patients' Cohort
Efficacy And Security Of Annual And Biennial Zoledronic Acid For Osteoporosis Treatment In An HIV-Infected Patients' Cohort
The purpose of this project is to determine the incidence of osteoporosis in the
 investigators' population of HIV-infected patients and to assess the efficacy and security of
 zoledronic acid, whose efficacy in post-menopausal women with high fracture risk treatment
 and in Paget's disease treatment has already been demonstrated.
The lower bone mineral density that has been described in patients with HIV-infection has not
 meant an increase of long term complications. Nevertheless, it could involve an increase if
 the associated co-morbidity in the future, taking in care that in general population
 osteoporosis increases 4 times the pathologic fracture risk. That is why it is necessary to
 know the real prevalence of osteoporosis in this population of patients so the real
 dimensions of the problems can be defined.

 This project wills to determine the incidence of osteoporosis in our population of
 HIV-infected patients and to assess the efficacy and security of zoledronic acid. If the
 annual use of endovenous zoledronic acid obtains equivalent results to those obtained with
 oral and weekly alendronate in other studies with the same population, its use would be
 justified because of its posology benefits. The annual administration can improve compliance
 in patients who are receiving a big quantity of drugs, as HIV-infected patients do, and who
 probably have to be treated for life. Moreover, its elimination is renal so there is absence
 of interactions with antiretroviral drugs what makes of zoledronic acid a very promising
 alternative. Finally, there is no risk of digestive intolerance because of its parenteral
 administration and it has a better posology than oral bisphosphonates.
Inclusion Criteria:

 1. 18 years old or older.

 2. Documented HIV-1 infection, with or without antiretroviral treatment.

 3. Presence of WHO osteoporosis criteria, defined as t-score under -2.5 in lumbar, hip
 and/or trochanter (DEXA in the last 6 months is needed).

 4. Willing to follow the study protocol.

 5. Informed Consent signature.

 Exclusion Criteria:

 1. In women, pregnancy or breastfeeding.

 2. Other possible causes of secondary osteoporosis.

 3. Creatinine over 2.3 mg/mL.

 4. Glomerular filter less than 50 mL/min (estimated through MDRD).

 5. Treatment for Osteoporosis in the last 4 months.