HIV-positive people are more likely to suffer broken bones than their age-matched HIV-negative peers, according to a new study published online in the Journal of Clinical Endocrinology & Metabolism. Authors Steven Grinspoon, MD, of Massachusetts General Hospital in Boston, and his colleagues argue that this is the first study to show a higher prevalence of fractures in HIV-positive people and ultimately adds to the seriousness of other studies finding significantly higher rates of low bone mineral density among those living with the virus.
Various studies have found higher rates of reduced bone mineral density—osteopenia and osteoporosis—in HIV-positive men and women compared with HIV-negative people of the same sex, race and age. While these findings allowed for the suggestion that people living with HIV are at a higher risk for bone fractures, there hasn't been any evidence to draw firm conclusions.
In the study reported by Dr. Grinspoon's group, 8,525 HIV-positive were compared with more than 2 million HIV-negative people receiving inpatient or outpatient care between 1996 and 2008 through the Boston-based Partners Healthcare System. Their medical records revealed that the fracture prevalence—of the spine, hip or wrist, the most common breakages associated with decreased bone mineral density—was 2.87 percent among the HIV-positive patients, compared with 1.77 percent among the HIV-negative patients.
Among HIV-positive females, the overall fracture prevalence was 2.49 percent-compared with 1.72 percent among the HIV-negative females. Among the HIV-positive males, the fracture prevalence was also higher in the HIV-infected compared with the HIV-negative patients: 3.08 versus 1.83 percent, respectively.
"As the HIV-infected population ages," the authors write, "reduced bone mineral density and increased fracture risk may become an even greater problem. Whether increased fractures are the [result] of antiretroviral therapy, increased rates of traditional risk factors such as low weight among HIV-infected patients, or HIV infection-and its accompanying metabolic and inflammatory disturbances-itself remains to be determined…. This study suggests the importance of assessing bone density and minimizing factors contributing to increased fracture risk in the HIV-infected population."
