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Archives of Osteoporosis

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01-12-2021 | Human Immunodeficiency Virus | Review

People with HIV infection had lower bone mineral density and increased fracture risk: a meta-analysis

Authors: Chao-Jui Chang, Yi-Lin Chan, Iqbal Pramukti, Nai-Ying Ko, Ta-Wei Tai

Published in: Archives of Osteoporosis | Issue 1/2021

Abstract

Summary

A meta-analysis to investigate the difference in fracture risk between individuals with and without HIV infection was performed. People living with HIV had lower bone mineral density (BMD) and greater risks of overall fractures and fragility fractures. Reducing fragility and maintaining skeletal strength for PLWH are urgently needed for this population.

Purpose

The introduction of effective antiretroviral therapy increased the life expectancy of people living with HIV (PLWH). This population now faces problems related to aging such as decreased bone mineral density (BMD) and increased fracture risk. Some antiretroviral therapies may also negatively impact bone health. We performed a meta-analysis to investigate the difference in the fracture risk between individuals with and without HIV infection.

Methods

We compared BMD, risk of fragility fracture, and risk of all fracture between the two groups. This study included 35 articles with 106,994 PLWH and 228,794,335 controls.

Results

PLWH had lower lumbar spine and hip BMD than controls. PLWH had a higher prevalence of all fracture events (4.08% versus 0.44%) and fragility fractures (2.66% versus 2.19%). The relative risks of all and fragility fractures of PLWH were 1.91 (95% confidence interval (CI), 1.46–2.49; p < 0.001) and 1.68 (95% CI: 1.40–2.01; p < 0.001). PLWH also had more vertebral fractures (1.26% versus 0.37%; RR, 1.97; 95% CI: 1.22–3.2; p < 0.05), hip fractures (1.38% versus 0.81%; RR, 1.88; 95% CI: 0.99–3.57; p = 0.05), and wrist fractures (1.38% versus 1.29%; RR, 1.67; 95% CI: 1.13–2.45; p < 0.05) than healthy controls. The pooled incidence of fractures was 1.72 per 100 person-years in PLWH and 1.29 in healthy controls.

Conclusion

PLWH had lower BMD and greater risks of all fractures and fragility fractures. Reducing fragility and maintaining skeletal strength for PLWH are urgently needed for this population.

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Title: People with HIV infection had lower bone mineral density and increased fracture risk: a meta-analysis
Authors: Chao-Jui Chang
Yi-Lin Chan
Iqbal Pramukti
Nai-Ying Ko
Ta-Wei Tai
Publication date: 01-12-2021
Publisher: Springer London
Keywords: Human Immunodeficiency Virus
Osteoporosis
Osteoporosis
Published in: Archives of Osteoporosis / Issue 1/2021
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-021-00903-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

People with HIV infection had lower bone mineral density and increased fracture risk: a meta-analysis

Abstract

Summary

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusion

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