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Comparative risk of fracture in men and women with HIV

Lydia Gedmintas1, Elizabeth A Wright, Elena Losina

  • 1Division of Rheumatology (L.G., E.L., J.N.K., D.H.S.), Immunology, and Allergy, Brigham and Women's Hospital, Boston, Massachusetts 02115; Orthopedic and Arthritis Center for Outcomes Research (E.A.W., E.L., J.N.K.), Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Biostatistics (E.L.), Boston University School of Public Health, Boston, Massachusetts 02118; Harvard Medical School (E.L., J.N.K., D.H.S.), Boston, Massachusetts 02115; and Division of Pharmacoepidemiology and Pharmacoeconomics (D.H.S.), Brigham and Women's Hospital, Boston, Massachusetts 02115.

The Journal of Clinical Endocrinology and Metabolism
|November 27, 2013
PubMed

Insights

Fracture rates were similar in men and women with human immunodeficiency virus (HIV). Further research is needed to determine if men with HIV require osteoporosis screening.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Bone Health

Background:

  • Individuals with human immunodeficiency virus (HIV) face a higher fracture risk than those without HIV.
  • It remains unclear if fracture incidence differs between men and women living with HIV.

Purpose of the Study:

  • To compare fracture incidence rates between men and women diagnosed with HIV.
  • To analyze fracture rates stratified by age and gender in the HIV-positive population.

Main Methods:

  • A cohort study design was employed, analyzing medical records from November 2001 to August 2012.
  • Data were collected from two tertiary-care hospitals in Boston, Massachusetts.
  • Adults (≥18 years) with HIV were included, defined by diagnostic codes, antiretroviral therapy prescription.

Main Results:

  • The study included 3161 HIV-infected patients (2292 men, 869 women), with 587 fractures documented.
  • The incidence rate ratio (IRR) for all fractures between men and women was 1.00 (95% CI 0.83-1.19).
  • For osteoporotic site fractures, the IRR was 1.26 (95% CI 0.90-1.75), with higher rates observed in men across most age groups.

Conclusions:

  • Fracture incidence rates were found to be similar between men and women living with HIV.
  • Additional research is necessary to confirm these findings and inform osteoporosis screening guidelines for men with HIV.
Abstract

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