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J Acquir Immune Defic Syndr. 2014 May 1;66(1):90-5. doi: 10.1097/QAI.0000000000000112.

HIV infection and its association with an excess risk of clinical fractures: a nationwide case-control study.

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  • 1*Oxford National Institute for Health Research (NIHR), Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; †Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; ‡Internal Medicine Department, Musculoskeletal Research Unit and Red Tematica de Investigacion Cooperativa en Envejecimiento y Fragilidad (RETICEF), Fundacio Institut Mar d'Investigacions Mediques (FIMIM), and Instituto de Salud Carlos III, Barcelona, Spain; §Institut d'Investigacio en Atencio Primaria (IDIAP), Jordi Gol-Primary Care Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; ‖Department of Internal Medicine and Infectious Diseases, Parc Salut Mar, Barcelona, Spain; ¶Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands; #Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, The Netherlands; **Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands; ††Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands; and ‡‡Aalborg Hospital, Aalborg University, Aalborg, Denmark.

Abstract

BACKGROUND:

Different studies have reported an association between HIV infection, antiretroviral therapies, and impaired bone metabolism, but data on their impact on fracture risk are scarce. We studied the association between a clinical diagnosis of HIV infection and fracture risk.

METHODS:

We conducted a case-control study using data from the Danish National Health Service registries, including 124,655 fracture cases and 373,962 age- and gender-matched controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression.

RESULTS:

A total of 50 (0.40/1000) patients in the fracture group and 52 (0.14/1000) controls had an HIV diagnosis. The risk of any fracture was thus significantly increased among HIV-infected patients (age- and gender-matched OR = 2.89, 95% CI: 1.99 to 4.18). Similarly, significant increases in the risk of hip (OR = 8.99, 95% CI: 1.39 to 58.0), forearm (OR = 3.50, 95% CI: 1.26 to 9.72), and spine fractures (OR = 9.00, 95% CI: 1.39 to 58.1) were observed.

CONCLUSIONS:

HIV infection is associated with an almost 3-fold increase in fracture risk compared with that of age- and gender-matched uninfected patients. HIV patients are also at an almost 9-fold higher risk of hip fracture.

PMID:
24457634
[PubMed - indexed for MEDLINE]
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