Increased risk of fragility fractures among HIV infected compared to uninfected male veterans
Authors
Womack, JulieGoulet, Joseph
Gibert, Cynthia
Brandt, Cynthia
Chang, Chung Chou
Gulanski, Barbara
Fraenkel, Liana
Mattocks, Kristin M.
Rimland, David
Rodriguez-Barradas, Maria
Tate, Janet
Yin, Michael T.
Justice, Amy
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2011-02-01Keywords
AgedAged, 80 and over
Bone Density
Follow-Up Studies
Fractures, Bone
HIV Infections
HIV-1
Humans
Male
Middle Aged
Osteoporosis
Risk Factors
Sex Characteristics
*Veterans
HIV infections
Bone fracture
Hip
HIV
Liver diseases
Proton pumps
Coronary heart disease
Alcohol consumption
Gender and Sexuality
Military and Veterans Studies
Musculoskeletal Diseases
Musculoskeletal System
Viruses
Metadata
Show full item recordAbstract
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.Source
PLoS One. 2011 Feb 16;6(2):e17217. doi: 10.1371/journal.pone.0017217. Link to article on publisher's site
DOI
10.1371/journal.pone.0017217Permanent Link to this Item
http://hdl.handle.net/20.500.14038/51028PubMed ID
21359191Related Resources
Rights
This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.ae974a485f413a2113503eed53cd6c53
10.1371/journal.pone.0017217