Young MSM may not completely recover from PrEP-related bone density loss

Adolescents who take pre-exposure prophylaxis, or PrEP, for HIV prevention may experience a loss of bone mineral density during treatment. Most patients can experience partial or full recovery of BMD within 48 weeks after discontinuing the medication, but a recent study published in Clinical Infectious Diseases suggested that teens aged 15 to 19 years may not make a full recovery, especially in lumbar spine and whole body BMD Z-scores.

“PrEP use in adolescents and young adult [men who have sex with men (MSM)] raises concerns because bone growth continues into early adulthood,” Peter L. Havens, MD, MS, professor in the department of pediatrics at the Medical College of Wisconsin and the Children’s Hospital of Wisconsin, and colleagues wrote. “Peak bone mass, typically achieved in the mid-20s, predicts bone fractures later in life. Drugs decreasing bone mass or limiting bone growth during adolescence might increase fracture risk during adulthood.”

The researchers examined data from a preplanned extension phase of two open-label studies of PrEP with emtricitabine and tenofovir disoproxil fumarate (FTC/TDF, Truvada) in young MSM aged 15 to 17 years and 18 to 22 years. The trials were identical and lasted 48 weeks. All participants who were included in the original trials who lost or failed to accrue bone or demonstrated signs of renal toxicity (n = 179) were included in the extension phase.

During the study, 12 participants discontinued treatment and 17 continued PrEP through other medical providers. The study was eventually narrowed down to 91 seronegative participants who had no further PrEP use following the trials and had one or more visit. Read more via Healio