The Effect of Alendronate, Calcium, and Vitamin D on Bone Mineral Density in HIV Infected Patients

Inclusion Criteria HIV-1 infection Lumbar spine DEXA scan confirming decreased BMD within 90 days prior to study entry CD4 cell count 100 cells/mm3 or more within 30 days prior to study entry Stable antiretroviral regimen for at least 12 weeks prior to study entry No plans to alter antiretroviral therapy or to initiate structured/strategic treatment interruptions No plans to significantly alter exercise habits or diet for the duration of the study Documentation of two consecutive measurements of viral load of 5000 copies/ml or less within 90 days prior to study entry, with at least one of the two values obtained within 30 days prior to study entry Willing to use acceptable methods of contraception For women with the absence of menses for at least 6 months, serum prolactin level in the normal range within 60 days prior to study entry For women taking estrogen therapy, stable estrogen regimen for at least 24 weeks prior to study entry, with no plan to change estrogen dose for the duration of the study Serum calcium between 8 mg/dl and 11 mg/dl within 30 days prior to study entry Exclusion Criteria Men with untreated low total serum testosterone levels within 60 days prior to study entry, or men with plans to initiate testosterone replacement during the study Cannot receive vitamin D or calcium supplements Daily vitamin or dietary supplements that include 10,000 IU or greater of vitamin A within 90 days prior to study entry Hyperparathyroidism, vitamin D deficiency, or oral thrush within 60 days prior to study entry Any current or past conditions that predispose to disorders involving the esophagus. Participants with a history of mild or controlled reflux may be enrolled. Esophagitis within 6 months prior to study entry Pregnant or breastfeeding Paget's disease Spinal fracture (thoracic or lumbar spine) within 60 days prior to study entry Atraumatic bone fracture at any time since 18 years of age Spinal fracture at any time in the past Inability to stand or sit upright for at least 30 minutes Use of systemic glucocorticoids for a cumulative duration of longer than 4 weeks within 6 months immediately prior to study entry Use of medications for treatment of osteoporosis within 12 months prior to study entry Allergy/hypersensitivity to any component of alendronate, the components of the tablet, or bisphosphonate compounds Active drug or alcohol dependence which, in the opinion of the investigator, would interfere with adherence to study requirements or would endanger the patient's health while on study Hospitalization for alcohol-related liver disease at any time in the past Current use of systemic cytotoxic chemotherapy Acute illness within 30 days prior to study entry which, in the opinion of the investigator, would interfere with participation in the study History of hepatitis C virus infection For participants using anabolic steroids, use of steroids for less than 6 months prior to entry or plans to change current regimen during the course of the study; if a steroid regimen has been discontinued, it must have been discontinued at least 6 months prior to entry