Bone fracture prevalence is higher among HIV-positive patients than among HIV-negative patients, according to a new study.
Dr. Steven K. Grinspoon of Harvard University and Massachusetts General Hospital and colleagues examined a large database at the hospital. The database included 8,525 HIV-positive and 2,208,792 HIV-negative persons who made at least one inpatient or outpatient visit to the facility between Oct. 1, 1996, and March 21, 2008. Prevalence of fracture in the two patient groups was evaluated.
The overall prevalence of bone fractures was 61 percent higher among the HIV-positive patients. Grinspoon said this proved to be true for men and women, and minority and non-minority patients. Most of the HIV patients were taking antiretrovirals.
Grinspoon said it remains unknown why the HIV patients were more likely to suffer broken bones. "Is it the HIV virus? Is it the medicines that are associated with HIV, that patients take for that? Is it some other mechanism? We simply don't know," he said.
In parts of the world where antiretrovirals are largely unavailable, Grinspoon said the risk of fractures might be as great or greater than for patients in the study population, even though the treatment-naïve patients might not live to ages where fractures are more common.
"Weight and nutrition is a huge factor for bone loss in any set of patients, HIV [or] not. And generally patients are better nourished here as opposed to developing countries where patients can be very, very thin and wasted. So there may be even more of a problem with bone density and fractures in those populations," Grinspoon said.
The report, "Fracture Prevalence Among Human Immunodeficiency Virus (HIV)-Infected Versus Non-HIV-Infected Patients in a Large US Healthcare System," was published in the Journal of Clinical Endocrinology & Metabolism (2008;93(9):3499-3504).
09/09/08
UNITED STATES: Risk of Fractures Higher in HIV-Infected Patients
Source: Voice of America:: Rose Hoban; Courtesy of the CDC National Center for HIV, STD, and TB Prevention