Mandibular Bone Microarchitecture Changes in Postmenopausal Women With and Without HIV

Michael Levit, CDM Class of 2025

Name: Michael Levit
School: College of Dental Medicine, Class of 2025
Mentor: Sunil Wadhwa, DDS and Michael Yin, MD, MS

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Women with HIV are living longer with effective antiretroviral therapy (ART) and transitioning intomenopause. HIV infection, ART and menopause are associated with bone loss at the spine and hip, but the impact of these combined factors on mandibular bone is uncertain. We hypothesized that mandibular bone mass would be lower and microarchitecture more abnormal in postmenopausal women with HIV compared to controls. A total of 119 postmenopausal women (72 HIV positive; 47 HIV negative; 51% African American, 44% Latina, and 5% White) were recruited at Columbia University Irving Medical Center. Cone Beam Computed Tomography was analyzed with Bruker Skyscan Ctan Software. The region of interest was standardized to the inferior coronal view of the mandible, offset from the mental foramen. Trabecular and cortical bone were segmented and analyzed with local thresholding. Analyzed parameters included: porosity, thickness, number, separation, and bone volume divided by total volume. Unpaired Student T tests and ANOVAs were used to determine differences between groups, p<0.05. Women with HIV had increased trabecular thickness and cortical bone volume fraction, but lower cortical porosity than controls. Effects were attenuated after stratifying by race/ethnicity, suggesting these results may be partly attributable to known racial differences in bone microarchitecture. Our results suggest that mandibular bone is not negatively impacted by HIV/ART. A larger sample size with balanced race/ethnicity will be needed to corroborate our findings among postmenopausal women. Additional complementary analyses within other regions of the mandible and comparisons between premenopausal women and men with and without HIV are ongoing.