A Cross-Sectional Randomised Study of Fracture Risk in People with HIV Infection in the Probono 1 Study

TY - JOUR

T1 - A Cross-Sectional Randomised Study of Fracture Risk in People with HIV Infection in the Probono 1 Study

AU - Peters, Barry S.

AU - Perry, Melissa

AU - Wierzbicki, Anthony S.

AU - Wolber, Lisa E.

AU - Blake, Glen M.

AU - Patel, Nishma

AU - Hoile, Richard

AU - Duncan, Alastair

AU - Kulasegaram, Ranjababu

AU - Williams, Frances M. K.

PY - 2013/10/29

Y1 - 2013/10/29

N2 - Objective: To determine comparative fracture risk in HIV patients compared with uninfected controls.Design: A randomised cross-sectional study assessing bone mineral density (BMD), fracture history and risk factors in the 2 groups.Setting: Hospital Outpatients.Subbbjects: 222 HIV infected patients and an equal number of age-matched controls. Assessments: Fracture risk factors were assessed and biochemical, endocrine and bone markers measured. BMD was assessed at hip and spine. 10-year fracture probability (FRAX) and remaining lifetime fracture probability (RFLP) were calculated.Main Outcome Measures: BMD, and history of fractures.Results: Reported fractures occurred more frequently in HIV than controls, (45 vs. 16; 20.3 vs. 7%; OR=3.27; p=0.0001), and unsurprisingly in this age range, non-fragility fractures in men substantially contributed to this increase. Osteoporosis was more prevalent in patients with HIV (17.6% vs. 3.6%, pConclusions: The increased fracture rate in HIV patients in our relatively youthful population is partly driven by fractures, including non-fragility fractures, in men. Nonetheless, these findings may herald a rise in osteoporotic fractures in HIV patients. An appropriate screening and management response is required to assess these risks and identify associated lifestyle factors that are also associated with other conditions such as cardiovascular disease and diabetes.

AB - Objective: To determine comparative fracture risk in HIV patients compared with uninfected controls.Design: A randomised cross-sectional study assessing bone mineral density (BMD), fracture history and risk factors in the 2 groups.Setting: Hospital Outpatients.Subbbjects: 222 HIV infected patients and an equal number of age-matched controls. Assessments: Fracture risk factors were assessed and biochemical, endocrine and bone markers measured. BMD was assessed at hip and spine. 10-year fracture probability (FRAX) and remaining lifetime fracture probability (RFLP) were calculated.Main Outcome Measures: BMD, and history of fractures.Results: Reported fractures occurred more frequently in HIV than controls, (45 vs. 16; 20.3 vs. 7%; OR=3.27; p=0.0001), and unsurprisingly in this age range, non-fragility fractures in men substantially contributed to this increase. Osteoporosis was more prevalent in patients with HIV (17.6% vs. 3.6%, pConclusions: The increased fracture rate in HIV patients in our relatively youthful population is partly driven by fractures, including non-fragility fractures, in men. Nonetheless, these findings may herald a rise in osteoporotic fractures in HIV patients. An appropriate screening and management response is required to assess these risks and identify associated lifestyle factors that are also associated with other conditions such as cardiovascular disease and diabetes.

KW - BONE-MINERAL DENSITY

KW - ANTIRETROVIRAL THERAPY

KW - COHORT

KW - OSTEOPOROSIS

KW - PREVALENCE

KW - RATES

U2 - 10.1371/journal.pone.0078048

DO - 10.1371/journal.pone.0078048

M3 - Article

SN - 1932-6203

VL - 8

JO - PL o S One

JF - PL o S One

IS - 10

M1 - e78048

ER -