Evidence-based screening for low bone mineral density in HIV-infected men.

Area of Science:

• Bone health and infectious diseases
• Osteoporosis screening and management
• Public health and HIV/AIDS care

Background:

• Low bone mineral density (BMD) and increased fracture risk are significant clinical issues in patients with HIV infection.
• Osteoporosis is an emerging health problem in the HIV-infected population, necessitating effective screening strategies.
• Early detection of low BMD is crucial for preventing fractures in this vulnerable group.

Purpose of the Study:

• To evaluate the effectiveness of screening tools for low bone mineral density in HIV-infected men.
• To determine the prevalence of low bone mineral density in a sample of HIV-infected men.
• To assess the diagnostic accuracy of the Osteoporosis Self-Assessment Tool (OST) and quantitative ultrasound (QUS) compared to dual-energy x-ray absorptiometry (DXA).

Main Methods:

• A convenience sample of 225 HIV-infected men was screened for low bone mineral density using the OST.
• 173 men were further screened using QUS of the calcaneus.
• 112 men identified with low BMD by either method underwent DXA for confirmation.

Main Results:

• 112 out of 225 men screened had low bone mineral density by OST or QUS.
• Of the 71 men tested by DXA, 73% were confirmed to have low bone mineral density.
• The positive predictive value for OST was 73%, and for QUS, it was 88%.

Conclusions:

• Low bone mineral density is highly prevalent in HIV-infected men.
• Quantitative ultrasound demonstrated a high positive predictive value for detecting low bone mineral density.
• Routine screening for low bone mineral density should be integrated into standard care for all HIV-infected patients.