Objectives: We aim to determine if there are bone mineral density, remodeling, and osteocyte lacunae density differences between midshaft femoral bone samples from individuals of known life history acquired from the University of Malawi College of Medicine (UMCOM).
Methods: Quantitative backscattered electron microscopy in the scanning electron microscope was performed to obtain images from individuals known to have had HIV/AIDS (n=8) and those who did not (n=4). Bone mineral density was evaluated by 8-bin grey-level histograms and compared using NIH-ImageJ. Osteocyte lacunae densities were measured using Leica QWin.
Results: Bone mineral density is relatively high, and the subpopulation of low density actively infilling osteons is relatively low in HIV/AIDS individuals, the latter result confirmed by absolutely higher numbers of osteonal osteocyte lacunae in completely infilled osteons.
Conclusions: Bone remodeling is suppressed in HIV/AIDS individuals. The formation of new matrix is inhibited and bone packets are allowed to age and increase in mineral density. Skeletal impairment in HIV/AIDS individuals increases fragility fractures. Regions that have significant numbers of HIV infected people and whose health care systems are unfamiliar with bone loss diseases – e.g. sub Saharan Africa – may be witnessing a crisis in the making. Although no research of this kind has been performed before, further study could lead to the development of drugs specifically designed to reduce the risk of fracture for those infected with the HIV virus.
Funding: NSF award BCS-1062680, the 2010 Max Planck Prize administered by the Max Planck Society and Alexander von Humboldt Foundation in support of the Hard Tissue Research Program in Human Paleobiomics, and the NYUCD Summer Research Program. Maggie Ndhlove, UMCOM, provided human specimens and life histories.
Keywords: Bone, Digital image analysis, HIV/AIDS, Mineralization and Remodeling