# Impact of estrogen replacement therapy on bone health in an aging population of women living with HIV

> **NIH NIH K01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2024 · $205,603

## Abstract

PROJECT SUMMARY / ABSTRACT
Current antiretroviral therapy (ART) regimens have rendered HIV a manageable chronic condition rather than a
fatal disease, with people who initiate ART soon after infection achieving nearly normal life expectancy. As a
consequence of increased survival, more women living with HIV (WLWH) will now undergo menopause and be
subject to a disease burden that reflects age along with adverse skeletal consequences of postmenopausal
estrogen deficiency. In addition to known bone loss and increased fracture risk in postmenopausal women, ART
also causes negative impacts on bone. Therefore ART-suppressed WLWH may have a compounded detrimental
effect on bone due to long-term ART treatment combined with menopause. We hypothesize that treatment with
estrogen replacement will attenuate the increased rate of bone loss during menopause and improve bone health
even with congruent administration of ART. We will address this hypothesis using a previously NIH-funded
project that employs a novel non-human primate model that replicates the sequence of acute infection, ART
initiation, chronic suppressed infection, and subsequent menopause now characteristic of a growing proportion
of aging WLWH. We intend to measure the impact of ART-suppression and menopause, with and without
hormone replacement therapy, on bone architecture and quality. Furthermore, we will determine whether bone
marrow, a known HIV reservoir, is deficient in necessary bone cell precursors. In conclusion, these studies will
examine bone health in an aging population of WLWH and potentially inform future care options utilizing hormone
replacement therapy to protect these women from compounded risk of bone fractures and osteoporosis.

## Key facts

- **NIH application ID:** 11008165
- **Project number:** 1K01AI183927-01A1
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Kristin AD Sauter
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $205,603
- **Award type:** 1
- **Project period:** 2024-08-06 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11008165

## Citation

> US National Institutes of Health, RePORTER application 11008165, Impact of estrogen replacement therapy on bone health in an aging population of women living with HIV (1K01AI183927-01A1). Retrieved via AI Analytics 2026-06-13 from https://api.ai-analytics.org/grant/nih/11008165. Licensed CC0.

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