Martin K, Lawson-Ayayi S, Miremont-Salamé G, Blaizeau M J, Balestre E, Lacoste D, Ragnaud J M, Malvy D, Dupon M, Mercié P, Schaeverbeke T, Haramburu F, Dabis F
Bordeaux Regional Pharmacovigilance Center, Pharmacology Department, Victor Segalen University, Centre Hospitalier Universitaire, Bordeaux, France.
HIV Med. 2004 Nov;5(6):421-6. doi: 10.1111/j.1468-1293.2004.00247.x.
Since the inception of highly active antiretroviral therapy (HAART), mortality among HIV-infected patients has decreased, but this has been accompanied by the appearance of several complications.
To estimate the incidence of symptomatic bone disorders in HIV-infected patients of the Aquitaine cohort (from south-west France) for the period 1999-2002, and to describe cases.
We retrospectively studied the records of 2700 patients of the Aquitaine cohort, which was derived from a hospital-based surveillance system of HIV infection in France. All cases of symptomatic bone disorders diagnosed from 1 January 1999 to 30 June 2002 were reviewed.
Fourteen cases of bone disorders were diagnosed, eight cases of aseptic osteonecrosis and six cases of severe osteoporosis, representing incidences of 0.3/1000 patient-years [95% confidence interval (CI): 0.14-0.62] and 0.22/1000 patient-years (95% CI: 0.09-0.52), respectively. All patients with aseptic osteonecrosis were male, while all but one with osteoporosis were female. The ages of patients ranged from 36 to 54 years for osteonecrosis and from 39 to 50 for severe osteoporosis. At the time of clinical diagnosis, all patients were treated with nucleoside reverse transcriptase inhibitors (duration of treatment ranging from 19 to 123 months for osteonecrosis and from 46 to 132 months for severe osteoporosis). Ten patients were treated with nonnucleoside reverse transcriptase inhibitors [duration of treatment ranging from 6 to 31 months for osteonecrosis (n=6) and from 4 to 29 months for severe osteoporosis (n=4)]. Thirteen patients were treated with protease inhibitors [duration of treatment ranging from 12 to 62 months for osteonecrosis (n=8) and from 3 to 44 months for severe osteoporosis (n=5)]. All osteonecrosis and five osteoporosis patients had at least one known risk factor or comorbidity associated with the bone disorder occurrence.
In our study, the aetiology of clinical bone disorders seemed to be multifactorial, as almost all the patients had at least one possible risk factor in addition to HAART exposure.
自高效抗逆转录病毒疗法（HAART）问世以来，HIV感染患者的死亡率有所下降，但同时也出现了一些并发症。
评估1999年至2002年期间阿基坦队列（来自法国西南部）中HIV感染患者出现有症状骨疾病的发生率，并描述这些病例。
我们回顾性研究了阿基坦队列中2700例患者的记录，该队列源自法国一个基于医院的HIV感染监测系统。对1999年1月1日至2002年6月30日期间诊断出的所有有症状骨疾病病例进行了审查。
共诊断出14例骨疾病病例，其中8例为无菌性骨坏死，6例为严重骨质疏松症，发生率分别为0.3/1000患者年[95%置信区间（CI）：0.14 - 0.62]和0.22/1000患者年（95%CI：0.09 - 0.52）。所有无菌性骨坏死患者均为男性，而除1例骨质疏松症患者外其余均为女性。骨坏死患者年龄在36至54岁之间，严重骨质疏松症患者年龄在39至50岁之间。在临床诊断时，所有患者均接受核苷类逆转录酶抑制剂治疗（骨坏死患者治疗时间为19至123个月，严重骨质疏松症患者治疗时间为46至132个月）。10例患者接受非核苷类逆转录酶抑制剂治疗[骨坏死患者（n = 6）治疗时间为6至31个月，严重骨质疏松症患者（n = 4）治疗时间为4至29个月]。13例患者接受蛋白酶抑制剂治疗[骨坏死患者（n = 8）治疗时间为12至62个月，严重骨质疏松症患者（n = 5）治疗时间为3至44个月]。所有骨坏死患者和5例骨质疏松症患者至少有一个已知的与骨疾病发生相关的危险因素或合并症。
在我们的研究中，临床骨疾病的病因似乎是多因素的，因为几乎所有患者除了接触HAART外，至少还有一个可能的危险因素。
