HIV infection and its association with an excess risk of clinical fractures: A nationwide case-control study
Prieto-Alhambra, Daniel; Güerri-Fernández, Robert; De Vries, Frank; Lalmohamed, Arief; Bazelier, Marloes; Starup-Linde, Jakob; Diez-Perez, Adolfo; Cooper, Cyrus; Vestergaard, Peter
(2014) Journal of Acquired Immune Deficiency Syndromes, volume 66, issue 1, pp. 90 - 95
(Article)
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
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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. © 2013 by Lippincott Williams and Wilkins.
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Keywords: bone, electronic health records, epidemiology, fratures, HIV, osteoporosis, anticonvulsive agent, corticosteroid, hypnotic sedative agent, adult, alcoholism, article, case control study, comorbidity, controlled study, Denmark, disease association, drug use, employment status, female, forearm fracture, fracture, hip fracture, human, Human immunodeficiency virus infected patient, Human immunodeficiency virus infection, income, major clinical study, male, marriage, population based case control study, priority journal, risk assessment, risk factor, spine fracture
ISSN: 1525-4135
Publisher: Lippincott Williams and Wilkins
(Peer reviewed)