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Patients with HIV at greater risk for bone fractures

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Patients infected with HIV have a higher prevalence of fractures than individuals not infected with the virus — a finding that applies to both genders and all critical fracture sites, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

“Prior studies have indicated reduced bone density in HIV-infected patients, but little was known whether fracture risk increased in this population,” Steven Grinspoon, MD, of Massachusetts General Hospital in Boston and the lead author of the study, said in a press release. “These data are the first to suggest that there is a clinically significant increase in bone fractures among HIV-infected patients, using data from a large health care system.”

In the study, researchers analyzed data from the Partners HealthCare System, which includes two primary hospitals from the Boston area: Brigham and Women’s Hospital and Massachusetts General Hospital. They studied fracture diagnoses from 1996 to 2008 in 8,525 HIV-infected patients and more than 2 million non-HIV-infected patients. Grinspoon and his colleagues found that the overall fracture prevalence increased more than 60% in HIV-infected patients versus patients without the infection, according to the press release.

The data in this study showed that patients with the infection had a significantly higher prevalence of vertebral, hip, wrist and combined fractures compared to those without HIV, Grinspoon said in the press release. Within both sexes, the fracture prevalence was higher in HIV-infected patients for the majority of sites assessed across age categories.

Grinspoon said the study found the relative difference in fracture prevalence between patients with HIV infection and those without it increases with age for both sexes. Therefore, as the HIV-infected population ages, reduced bone mineral density and increased fracture risk may become an even greater problem.

“HIV patients at risk for low bone density should be assessed and potentially treated to prevent fractures,” he said in the press release. “Further research is needed into the mechanisms of bone loss in this population.”

For more information:

• Grinspoon S, Brown T, Triant V, Lee H. Fracture prevalence among HIV-infected versus non-HIV-infected patients in a large U.S. healthcare system. J Clin Endocrinol Metab. In press.