HIV Infection and Its Association With an Excess Risk of Clinical Fractures: A Nationwide Case-Control Study

D. Prieto-Alhambra, R. Güerri-Fernández, F. de Vries, A. Lalmohamed, M. Bazelier, J. Starup-Linde, A. Diez-Perez, C. Cooper, P. Vestergaard

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)90-95
Number of pages6
JournalJaids-journal of Acquired Immune Deficiency Syndromes
Volume66
Issue number1
DOIs
Publication statusPublished - 1 May 2014

Keywords

  • epidemiology
  • HIV
  • fratures
  • bone
  • osteoporosis
  • electronic health records
  • BONE-MINERAL DENSITY
  • POPULATION-BASED COHORT
  • ANTIRETROVIRAL THERAPY
  • TNF-ALPHA
  • PREVALENCE
  • COMORBIDITIES
  • OSTEOPOROSIS
  • OSTEOPENIA
  • TENOFOVIR
  • DISEASE

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