NEW MICROBIOLOGICA, 36, 345-351, 2013 Phalangeal quantitative ultrasound: cheaper methods for screening and follow-up of bone pathologies in HIV-infected women? Roberta Prinapori 1 , Raffaella Rosso 1 , Antonio Di Biagio 1 , Laura Nicolini 1 , Daniele Roberto Giacobbe 1 , Laura De Hoffer 1 , Sara Grignolo 1 , Francesca De Terlizzi 2 , Marina Vignolo 3 , Marco Borderi 4 , Giulia Martelli 4 , Leonardo Calza 4 , Pierluigi Viale 4 , Fabio Vescini 5 , Claudio Viscoli 1 1 Department of Internal Medicine and Infectious Diseases, IRCCS A.O.U. San Martino-IST, Genoa, Italy; 2 Medical Office, IGEA s.r.l., Modena, Italy; 3 Paediatric Clinic, University of Genoa, G. Gaslini Institute; 4 Department of Medical and Surgical Sciences, Section of Infectious Diseases, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy; 5 Endocrinology and Metabolism Unit, University-Hospital S. Maria della Misericordia, Udine, Italy INTRODUCTION Low bone mass is a well-recognized metabolic complication associated with HIV infection in men and women (Walker Harris and Brown, 2012). As for the other toxicities related to HIV and combined antiretroviral therapy (cART), medical attention has been distracted from the Corresponding author Antonio Di Biagio Clinica Malattie Infettive IRCCS A.O.U. San Martino-IST Largo Rosanna Benzi, 10 16132 Genova, Italy E-mail: antonio.dibiagio@hsanmartino.it management of HIV infection to the care of os- teopenia or osteoporosis (Morse and Kovacs, 2006). The high prevalence of HIV-related os- teoporosis is likely the result of heterogeneous causes and the interplay of host, viral and spe- cific antiretroviral factors (Morse and Kovacs, 2006; Amorosa and Tebas, 2006; Cazanave et al., 2008; Gibellini et al., 2010). Bone is constantly undergoing a remodelling process, in a synchro- nized balance between resorption and formation, which can be altered during HIV-infection. A di- rect effect of HIV on bone cells, the persistent activation of pro-inflammatory cytokines and al- terations in the metabolism of vitamin D have most often been addressed as possible causes of HIV-related osteoporosis even though we are still This study estimated the prevalence of bone pathologies in a cohort of HIV-infected women in comparison with a co- hort of HIV-negative women. Bone mineral density was measured by phalangeal quantitative ultrasound (AD-SoS: am- plitude-dependent speed of sound; UBPI:ultrasound bone profile index). Risk of fracture, expressed by UBPI, was con- sidered for value <0.39. Comparisons between groups and multivariate analyses were carried out using an ANOVA mod- el. Correlations were evaluated using the Pearson correlation coefficient. Osteopenia and osteoporosis were present in 34.4% and 2% of patients, respectively. UBPI was pathologic in 5.7%. In a multivariate linear regression model sig- nificant correlations were found between AD-SoS z-score, duration of HIV-infection and BMI value. We also compared our cohort with 499 HIV-negative women as a historical control group of healthy subjects. AdSoS (2100 versus 2070 m/s) and UBPI (0.89 versus 0.74) were lower in HIV-infected women (p<0.001). Significant differences were also found in T-score values (p = 0.0013). These data show a high prevalence of bone diseases in women with HIV infec- tion, correlated with duration of HIV-infection and BMI values. This non-invasive technique opens up new interest- ing perspectives, suggesting a possible use for bone mass screening in HIV-infected women. KEY WORDS: Quantitative ultrasound, HIV infection, Women, Bone diseases, Osteopenia, Fracture. SUMMARY Received December 18, 2012 Accepted July 27, 2013