Decreased bone mineral density and increased fracture risk in aging men with or at risk for HIV infection
- 12 March 2007
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in AIDS
- Vol. 21 (5), 617-623
- https://doi.org/10.1097/qad.0b013e3280148c05
Abstract
Background: Osteopenia has been described in HIV-infected persons, but most studies have not focused on aging men, have not included an HIV-negative comparison group with similar risks to those of the HIV-infected men, or lacked data on fracture rates. Methods: We analyzed bone mineral density (BMD) and incident fractures in 559 men who were ≥ 49 years old with or at-risk for HIV, including 328 with and 231 without HIV infection. Results: Median age was 55 years, 56% were black and 89% had used illicit drugs. In unadjusted analysis, BMD was lower in HIV-infected compared with HIV-uninfected men at the femoral neck (0.97 ± 0.14 versus 1.00 ± 0.15 g/cm2; P < 0.05) and lumbar spine (1.17 ± 0.20 versus 1.20 ± 0.21 g/cm2; P = 0.06); both differences were significant (P < 0.05) after adjusting for age, weight, race, testosterone level, and prednisone and illicit drug use. Non-black race and body weight were independently associated with BMD at both measurement sites and methadone therapy was independently associated with spine BMD. Among HIV-infected men, 87% had taken antiretrovirals and 74% had taken protease inhibitors, but their use was not associated with BMD. Among men who had at least one subsequent study visit (94%), incident fracture rates per 100 person-years differed among men with normal BMD, osteopenia and osteoporosis (1.4 versus 3.6 versus 6.5; P < 0.01). A 38% increase in fracture rate among HIV-infected men was not statistically significant. Conclusions: HIV infection is independently associated with modestly reduced BMD in aging men, and decreased BMD is associated with increased fracture risk.Keywords
This publication has 36 references indexed in Scilit:
- Androgen levels in older men who have or who are at risk of acquiring HIV infection.Clinical Infectious Diseases, 2005
- Osteopenia and osteoporosis in HIV+ patients, untreated or receiving HAARTBiomedicine & Pharmacotherapy, 2004
- Efficacy and Safety of Tenofovir DF vs Stavudine in Combination Therapy in Antiretroviral-Naive PatientsA 3-Year Randomized TrialJAMA, 2004
- BMD Is Reduced in HIV-Infected Men Irrespective of TreatmentJournal of Bone and Mineral Research, 2004
- Overweight and Human Immunodeficiency Virus (HIV) Progression in Women: Associations HIV Disease Progression and Changes in Body Mass Index in Women in the HIV Epidemiology Research Study CohortClinical Infectious Diseases, 2003
- Opiate Drug Use: A Potential Contributor to the Endocrine and Metabolic Complications in Human Immunodeficiency Virus DiseaseClinical Infectious Diseases, 2003
- Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapyAIDS, 2003
- Longitudinal Evolution of Bone Mineral Density and Bone Markers in Human Immunodeficiency Virus–Infected IndividualsClinical Infectious Diseases, 2003
- Osteopenia in HIV-infected patients: is it the disease or is it the treatment?AIDS, 2001
- Prevalence and Predictive Value of Overweight in an Urban HIV Care ClinicJAIDS Journal of Acquired Immune Deficiency Syndromes, 2001