Research suggests HIV-infected patients at higher risk for bone fractures

Low bone mineral density in HIV-infected patients is common and raises concerns about increased risks of fracture. Although there have been several studies regarding bone mineral density, there have been few data on rates of fracture in this population. A new study published in Clinical Infectious Diseases and available online examined differences in the rates of bone fractures between HIV-infected patients and the general population and found higher rates of fracture among HIV patients.

A total of 5,826 HIV-infected patients were analyzed from 2000 to 2008 in the study. The researchers were able to compare rates with persons in the general U.S. population for the period from 2000 to 2006 and observed that annual fracture rates among HIV-infected patients were between 1.98 and 3.69 times greater.

"We confirmed that several established risk factors for fracture, such as age, substance abuse, hepatitis C co-infection, and diabetes, were associated with fractures among the HIV-infected patients," said study author Benjamin Young, MD, PhD, of the Rocky Mountain Center for AIDS Research, Education, and Services in Denver. "This study also highlights for the first time a potential association between fracture risk and CD4 cell count. The optimal clinical management of bone health in HIV-infected individuals is not well defined and remains controversial."

Dr. Young added, "We believe our data support the need to develop guidelines that address screening for and correcting reversible causes of low bone mineral density and fall risk and that these activities should be incorporated into the routine care of HIV-infected patients."