Increased Risk of Fragility Fractures among HIV Infected Compared to Uninfected Male VeteransReportar como inadecuado




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Background

HIV infection has been associated with an increased risk of fragility fracture. We explored whether or not this increased risk persisted in HIV infected and uninfected men when controlling for traditional fragility fracture risk factors.

Methodology-Principal Findings

Cox regression models were used to assess the association of HIV infection with the risk for incident hip, vertebral, or upper arm fracture in male Veterans enrolled in the Veterans Aging Cohort Study Virtual Cohort VACS-VC. We calculated adjusted hazard ratios comparing HIV status and controlling for demographics and other established risk factors. The sample consisted of 119,318 men, 33% of whom were HIV infected 34% aged 50 years or older at baseline, and 55% black or Hispanic. Median body mass index BMI was lower in HIV infected compared with uninfected men 25 vs. 28 kg-m2; p<0.0001. Unadjusted risk for fracture was higher among HIV infected compared with uninfected men HR: 1.32 95% CI: 1.20, 1.47. After adjusting for demographics, comorbid disease, smoking and alcohol abuse, HIV infection remained associated with an increased fracture risk HR: 1.24 95% CI: 1.11, 1.39. However, adjusting for BMI attenuated this association HR: 1.10 95% CI: 0.97, 1.25. The only HIV-specific factor associated with fragility fracture was current protease inhibitor use HR: 1.41 95% CI: 1.16, 1.70.

Conclusions-Significance

HIV infection is associated with fragility fracture risk. This risk is attenuated by BMI.



Autor: Julie A. Womack , Joseph L. Goulet, Cynthia Gibert, Cynthia Brandt, Chung Chou Chang, Barbara Gulanski, Liana Fraenkel, Kristin M

Fuente: http://plos.srce.hr/



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