Jennifer Hoy1, Benjamin Young. 1. aDepartment of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia bInternational Association of Providers of AIDS Care, Washington, District of Columbia, USA.
Abstract
PURPOSE OF REVIEW: This review details recent findings that inform the prevalence and incidence of fractures in people living with HIV (PLWH) and examines the effects of HIV infection and antiretroviral therapy (ART), as well as demographics and traditional risk factors on fractures. As antiretroviral guidelines have recently changed to recommend the introduction of ART at diagnosis of HIV infection, the long-term effects of ART on bone health and fracture risk need to be better understood. RECENT FINDINGS: It is apparent that both the effects of HIV infection alone and initiation of ART are associated with significant bone loss in individuals with HIV infection, resulting in osteopenia and osteoporosis. The clinical consequence of low bone mineral density is a greater risk of fragility fractures that are more common in older HIV patients, and those on ART. Frailty occurs at a prevalence of about 10% (about twice that of the general population), and the increased propensity of falls results in greater fracture prevalence, morbidity and mortality. SUMMARY: This review examines data from recent cohort studies and clinical trials to inform a better understanding of the complex relationship between the effects of HIV infection, ART and demographics on fractures in PLWH.
PURPOSE OF REVIEW: This review details recent findings that inform the prevalence and incidence of fractures in people living with HIV (PLWH) and examines the effects of HIV infection and antiretroviral therapy (ART), as well as demographics and traditional risk factors on fractures. As antiretroviral guidelines have recently changed to recommend the introduction of ART at diagnosis of HIV infection, the long-term effects of ART on bone health and fracture risk need to be better understood. RECENT FINDINGS: It is apparent that both the effects of HIV infection alone and initiation of ART are associated with significant bone loss in individuals with HIV infection, resulting in osteopenia and osteoporosis. The clinical consequence of low bone mineral density is a greater risk of fragility fractures that are more common in older HIVpatients, and those on ART. Frailty occurs at a prevalence of about 10% (about twice that of the general population), and the increased propensity of falls results in greater fracture prevalence, morbidity and mortality. SUMMARY: This review examines data from recent cohort studies and clinical trials to inform a better understanding of the complex relationship between the effects of HIV infection, ART and demographics on fractures in PLWH.
Authors: Jennifer F Hoy; Birgit Grund; Mollie Roediger; Ann V Schwartz; John Shepherd; Anchalee Avihingsanon; Sharlaa Badal-Faesen; Stephane de Wit; Simone Jacoby; Alberto La Rosa; Sanjay Pujari; Mauro Schechter; David White; Nicole Wyman Engen; Kristine Ensrud; Peer D Aagaard; Andrew Carr Journal: J Bone Miner Res Date: 2017-06-26 Impact factor: 6.741
Authors: Grace A McComsey; Sergio Lupo; David Parks; Mónica Coronado Poggio; Joseph De Wet; Lesley P Kahl; Kostas Angelis; Brian Wynne; Kati Vandermeulen; Martin Gartland; Michael Cupo; Michael Aboud Journal: AIDS Date: 2018-02-20 Impact factor: 4.177
Authors: Galateia J Kazakia; Julio Carballido-Gamio; Andrew Lai; Lorenzo Nardo; Luca Facchetti; Courtney Pasco; Chiyuan A Zhang; Misung Han; Amanda Hutton Parrott; Phyllis Tien; Roland Krug Journal: Quant Imaging Med Surg Date: 2018-02