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

Barry S. Peters*, Melissa Perry, Anthony S. Wierzbicki, Lisa E. Wolber, Glen M. Blake, Nishma Patel, Richard Hoile, Alastair Duncan, Ranjababu Kulasegaram, Frances M. K. Williams

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)

Abstract

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%, p

Conclusions: 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.

Original languageEnglish
Article numbere78048
Number of pages9
JournalPL o S One
Volume8
Issue number10
DOIs
Publication statusPublished - 29 Oct 2013

Keywords

  • BONE-MINERAL DENSITY
  • ANTIRETROVIRAL THERAPY
  • COHORT
  • OSTEOPOROSIS
  • PREVALENCE
  • RATES

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