Short Charlotte-Eve S, Shaw Simon G, Fisher Martin J, Walker-Bone Karen, Gilleece Yvonne C
Department of HIV Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Int J STD AIDS. 2014 Feb;25(2):113-21. doi: 10.1177/0956462413492714. Epub 2013 Jul 19.
Rates of osteoporosis and fracture may be increased in HIV but there are few UK data. Our aim was to examine the prevalence of and risk factors for osteoporosis and fractures among a homogeneous cohort of well-characterized HIV-infected men. In total, 168 men were recruited, median age 45 years, 37 combination antiretroviral therapy (cART) naïve, 46 with <3 years cART exposure and 85 cART-exposed longer term (median >10 years). All participants provided information on bone health and underwent DEXA scanning. Osteopenia was found in 58% of subjects and osteoporosis in 12%; 14% reported fractures since HIV diagnosis. Number of fractures since HIV diagnosis was significantly increased among those with osteoporosis (OR 3.5, 95% CI 1.2-10.4, p = 0.018). Duration of infection greater than 13 years was significantly associated with osteoporosis. Duration of cART was associated in univariate but not multivariate analyses. Strategies to prevent osteoporosis and fractures in HIV will require attention to viral and lifestyle factors and not just cART.
在感染艾滋病毒的人群中，骨质疏松症和骨折的发生率可能会升高，但英国这方面的数据很少。我们的目的是在一组特征明确的、感染艾滋病毒的男性同质性队列中，研究骨质疏松症和骨折的患病率及危险因素。总共招募了168名男性，中位年龄45岁，其中37人未接受过联合抗逆转录病毒治疗（cART），46人接受cART治疗不到3年，85人长期接受cART治疗（中位时间>10年）。所有参与者都提供了骨骼健康信息并接受了双能X线吸收法扫描。58%的受试者存在骨质减少，12%患有骨质疏松症；14%的人报告自诊断艾滋病毒以来发生过骨折。自诊断艾滋病毒以来，骨质疏松症患者的骨折次数显著增加（比值比3.5，95%置信区间1.2 - 10.4，p = 0.018）。感染持续时间超过13年与骨质疏松症显著相关。cART治疗时间在单变量分析中有相关性，但在多变量分析中无相关性。预防艾滋病毒感染者骨质疏松症和骨折的策略需要关注病毒和生活方式因素，而不仅仅是cART治疗。
