HIV patients at higher risk for bone fractures--study
There are several strong or moderate risk factors that contribute to fracture risk. These include risky behaviors, associated conditions, protective factors, age, prior fragility fracture, a parental history of hip fracture, smoking, use of systemic corticosteroids, excess alcohol intake and rheumatoid arthritis.
HIV patients suffer more fractures
Adding more to these risk factors, a new study suggests that individuals with HIV infections have higher rates of bone fractures than the general US population.
The researchers believe that the contagious HIV virus seize the body on many levels including bone mineral density (BMD), which in turn causes a higher frequency of bone fractures.
Low BMD in HIV-infected patients is common, with presence in 67 percent of HIV-infected individuals. The lack of BMD makes this population prone to increased risks of fracture. Although there have been several studies regarding bone mineral density, only a few have examined the rate of bone fractures among persons infected with HIV.
Study details and findings
To examine whether HIV-positive patients are at greater risk for bone fractures, researchers at the Rocky Mountain Center for AIDS Research, Education, and Services, analyzed data from the HIV Outpatient Study (HOPS), which is an open prospective cohort study of HIV-infected adults.
The researchers analyzed a total of 5,826 HIV-infected patients from 2000 to 2008 in the study.
After comparing the rate of bone fractures among the HIV and the general populations, the researchers found that rates among the HIV population were up to four times higher.
More precisely, the annual bone fracture rates were between 1.98 and 3.69 times higher among the HIV-infected patients, the study found.
"We confirmed that several established risk factors for fracture, such as age, substance abuse, hepatitis C co-infection and diabetes were associated with fractures among HIV-infected patients," study lead author Dr. Benjamin Young of the Rocky Mountain Center for AIDS Research, Education and Services in Denver said in a news release.
“This study also highlights for the first time a potential association between fracture risk and CD4 cell count. The optimal clinical management of bone health in HIV-infected individuals is not well defined and remains controversial," Young added.
According to the study, CD4 cells are immune system cells that HIV infects and destroys.
Researchers hope to develop new treatment for HIV patients
Young and colleagues hope their findings would likely help develop new guidelines that aim to reduce causing low bone density when treating HIV, and reduce patients' risk of falling.
"We believe our data support the need to develop guidelines that address screening for and correcting reversible causes of low bone mineral density and fall risk and that these activities should be incorporated into the routine care of HIV-infected patients," Young concluded.
The study has been published in the online version of the journal 'Clinical Infectious Diseases.'