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Title: Fracture Prevalence Is Significantly Higher in HIV-Infected Patients
URL: http://www.pslgroup.com/dg/22A1DA.htm
Doctor's Guide
August 28, 2008

BOSTON -- August 28, 2008 -- Fracture prevalence increases by more than 60% in those infected with HIV compared with patients who are HIV-negative, according to a study published in the September issue of Journal of Clinical Endocrinology and Metabolism.

"This is the largest investigation to date to compare fracture rates in HIV-infected patients with those of non-infected controls," said senior author Steven Grinspoon, MD, Neuroendocrine Unit and Program in Nutritional Metabolism, Massachusetts General Hospital (MGH), and Harvard Medical School, Boston, Massachusetts.

"This very large study group -- with more than 8,500 HIV-infected patients and over 2 million controls -- has the power to detect significant differences in risk for both men and women at critical sites such as the hip and spine, risks that increased with age."

Previous studies of the impact of HIV on bone health focused on bone density and reported increased prevalence of osteoporosis and osteopenia in HIV-infected men and women, but evaluation of the consequences of these conditions was limited.

The researchers utilised the Partners HealthCare System Research Patient Data Registry, which includes demographic and diagnostic information on patients treated at MGH and Brigham and Women's Hospital in Boston.

Their analysis of data from patients treated over an 11-year period revealed that almost 2.9% of HIV patients were diagnosed with fractures of the hip, spine, or wrist, while fracture prevalence was only 1.8% percent in non-HIV-infected patients.

Increases in HIV-associated fracture rates were seen in both men (3% vs 1.8%) and women (2.5% vs 1.7%). There was also a more pronounced increased risk in older patients.

"These data indicate that we should screen HIV-infected patients, both men and women, for low bone density as they age," said Dr. Grinspoon.

"We also need to learn more about the mechanisms of this bone loss -- whether antiviral drugs, the virus itself, or other metabolic factors are responsible -- and investigate specific fracture rates for women before and after menopause."


SOURCE: Massachusetts General Hospital

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