HIV-infected patients have a higher prevalence of fractures than non HIV-infected patients, across both genders and critical fracture sites according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
"Prior studies have indicated reduced bone density in HIV-infected patients, but little was known whether fracture risk increased in this population," said Dr. Steven Grinspoon, M.D., of Massachusetts General Hospital in Boston and lead author of the study. "These data are the first to suggest that there is a clinically significant increase in bone fractures among HIV-infected patients, using data from a large healthcare system."
In this study, researchers analyzed data from the Partners HealthCare System, which includes two primary hospitals, Brigham and Women's Hospital and Massachusetts General Hospital. They studied fracture diagnoses from 1996 to 2008 in 8,525 HIV-infected patients and more than 2 million non HIV-infected patients. Dr. Grinspoon and his colleagues found that overall fracture prevalence increased more than 60 percent in HIV-infected patients versus non HIV-infected patients.
The data in this study showed HIV-infected patients had a significantly higher prevalence of vertebral, hip, wrist, and combined fractures compare to non HIV-infected patients. Within both sexes, fracture prevalence was higher in HIV-infected patients for the majority of sites assessed, across age categories.
Dr. Grinspoon said the study found the relative difference in fracture prevalence between HIV-infected patients and non HIV-infected patients increases with age for both sexes. Therefore, as the HIV-infected population ages, reduced bone mineral density and increased fracture risk may become an even greater problem.
"HIV patients with risk for low bone density should be assessed and potentially treated to prevent fractures," said Dr. Grinspoon. "Further research is needed into the mechanisms of bone loss in this population."
Other researchers working on the study include Todd Brown of Johns Hopkins University in Baltimore, Md. and Virginia Triant and Hang Lee of Massachusetts General Hospital in Boston.
- Virginia A. Triant, Todd T. Brown, Hang Lee, and Steven K. Grinspoon. Fracture Prevalence among HIV-Infected versus Non HIV-Infected Patients in a Large U.S. Healthcare System. Journal of Clinical Endocrinology & Metabolism, Published July 1, 2008 DOI: 10.1210/jc.2008-0828
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