PMID- 25033046
OWN - NLM
STAT- MEDLINE
DCOM- 20151218
LR  - 20180406
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 9
IP  - 7
DP  - 2014
TI  - The effect of HIV-hepatitis C co-infection on bone mineral density and fracture: 
      a meta-analysis.
PG  - e101493
LID - 10.1371/journal.pone.0101493 [doi]
AB  - OBJECTIVE: There is a variable body of evidence on adverse bone outcomes in HIV
      patients co-infected with hepatitis C virus (HCV). We examined the association of
      HIV/HCV co-infection on osteoporosis or osteopenia (reduced bone mineral density;
      BMD) and fracture. DESIGN: Systematic review and random effects meta-analyses.
      METHODS: A systematic literature search was conducted for articles published in
      English up to 1 April 2013. All studies reporting either BMD (g/cm2, or as a
      T-score) or incident fractures in HIV/HCV co-infected patients compared to either
      HIV mono-infected or HIV/HCV uninfected/seronegative controls were included.
      Random effects meta-analyses estimated the pooled odds ratio (OR) and the
      relative risk (RR) and associated 95% confidence intervals (CI). RESULTS:
      Thirteen eligible publications (BMD N = 6; Fracture = 7) of 2,064 identified were
      included with a total of 427,352 subjects. No publications reported data on HCV
      mono-infected controls. Meta-analysis of cross-sectional studies confirmed that
      low bone mineral density was increasingly prevalent among co-infected patients
      compared to HIV mono-infected controls (pooled OR 1.98, 95% CI 1.18, 3.31) but
      not those uninfected (pooled OR 1.47, 95% CI 0.78, 2.78). Significant association
      between co-infection and fracture was found compared to HIV mono-infected from
      cohort and case-control studies (pooled RR 1.57, 95% CI 1.33, 1.86) and compared 
      to HIV/HCV uninfected from cohort (pooled RR 2.46, 95% CI 1.03, 3.88) and
      cross-sectional studies (pooled OR 2.30, 95% CI 2.09, 2.23). CONCLUSIONS: The
      associations of co-infection with prevalent low BMD and risk of fracture are
      confirmed in this meta-analysis. Although the mechanisms of HIV/HCV
      co-infection's effect on BMD and fracture are not well understood, there is
      evidence to suggest that adverse outcomes among HIV/HCV co-infected patients are 
      substantial.
FAU - O'Neill, Tyler J
AU  - O'Neill TJ
AD  - Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario,
      Canada.
FAU - Rivera, Laura
AU  - Rivera L
AD  - Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario,
      Canada.
FAU - Struchkov, Vladi
AU  - Struchkov V
AD  - Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario,
      Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
FAU - Zaheen, Ahmad
AU  - Zaheen A
AD  - Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
FAU - Thein, Hla-Hla
AU  - Thein HH
AD  - Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario,
      Canada; Ontario Institute for Cancer Research/Cancer Care Ontario, Toronto,
      Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20140717
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adult
MH  - Anti-HIV Agents/therapeutic use
MH  - Bone Density
MH  - Coinfection/*epidemiology
MH  - Female
MH  - Fractures, Bone/*epidemiology
MH  - HIV Infections/drug therapy/*epidemiology
MH  - Hepatitis C/*epidemiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Osteoporosis/*epidemiology
MH  - Risk Factors
MH  - Treatment Outcome
PMC - PMC4102482
EDAT- 2014/07/18 06:00
MHDA- 2015/12/19 06:00
CRDT- 2014/07/18 06:00
PHST- 2013/12/11 00:00 [received]
PHST- 2014/06/06 00:00 [accepted]
PHST- 2014/07/18 06:00 [entrez]
PHST- 2014/07/18 06:00 [pubmed]
PHST- 2015/12/19 06:00 [medline]
AID - 10.1371/journal.pone.0101493 [doi]
AID - PONE-D-13-51538 [pii]
PST - epublish
SO  - PLoS One. 2014 Jul 17;9(7):e101493. doi: 10.1371/journal.pone.0101493.
      eCollection 2014.