Departments of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan.
Department of Life Science, Chinese Culture University, Taipei, Taiwan.
Arch Osteoporos. 2021 Feb 27;16(1):47. doi: 10.1007/s11657-021-00903-y.
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.
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.
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.
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.
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.
有效的抗逆转录病毒疗法的引入提高了艾滋病毒感染者（PLWH）的预期寿命。该人群现在面临与衰老相关的问题，例如骨密度（BMD）下降和骨折风险增加。一些抗逆转录病毒疗法也可能对骨骼健康产生负面影响。我们进行了一项荟萃分析，以研究感染 HIV 与未感染 HIV 的个体之间骨折风险的差异。
我们比较了两组之间的 BMD、脆性骨折风险和所有骨折风险。这项研究包括 35 篇文章，涉及 106994 名 PLWH 和 228794335 名对照者。
PLWH 的腰椎和髋部 BMD 低于对照组。PLWH 全骨折事件（4.08%对 0.44%）和脆性骨折（2.66%对 2.19%）的发生率更高。PLWH 的所有和脆性骨折的相对风险分别为 1.91（95%置信区间（CI）：1.46-2.49；p<0.001）和 1.68（95%CI：1.40-2.01；p<0.001）。PLWH 还发生了更多的椎体骨折（1.26%对 0.37%；RR，1.97；95%CI：1.22-3.2；p<0.05）、髋部骨折（1.38%对 0.81%；RR，1.88；95%CI：0.99-3.57；p=0.05）和腕部骨折（1.38%对 1.29%；RR，1.67；95%CI：1.13-2.45；p<0.05）多于健康对照者。PLWH 骨折的累积发生率为每 100 人年 1.72 例，健康对照者为 1.29 例。
PLWH 的 BMD 较低，全骨折和脆性骨折的风险较高。对于该人群，迫切需要降低脆弱性并维持骨骼强度。
