This Canadian study of bone health showed that HIV+ women were more likely to have had fragility fractures (OR 1.7) but had BMD values that were not different than women from a national population-based cohort.
Introduction
Given that 17.5 million women globally are HIV-infected and living longer on anti-retroviral therapy (ART+), it is essential to determine whether they are at risk for osteoporosis as is currently assumed.
Methods
Assessment of osteoporosis risk factors and lifetime low-trauma (fragility) fracture history used a common interviewer-administered questionnaire and phantom-adjusted bone mineral density (BMD). This study compared HIV+ Canadian women with ageand region-matched control women (1:3) from a national population-based study of osteoporosis.
Results
One hundred and thirty-eight HIV+ women (100 ART+, 38 ART-) were compared with 402 controls. There were no differences in age (37.7 vs. 38.0 years), BMI (25.0 vs. 26.2), family history of osteoporosis, exercise history, alcohol or calcium intakes, age at menarche, oral contraceptive use or parity. HIV+ cases included more Aboriginal and Black women (12.5% and 16.2 vs. 2% and 1%, respectively), smoked and used injection drugs (53%) more, were more often treated with glucocorticoids, had oligomenorrhea, and reported 10-kg weight cycling. Significantly more HIV+ women reported lifetime fragility fractures (26.1% vs. 17.3; OR 1.7, 95% CI 1.1, 2.6). HIV+ and control women did not differ in BMD: spine 1.0 +/- 0.12 vs.1.0 +/- 0.14 g/cm(2) (diff. 0.0, 95% CI -0.27, 0.27) or total femur 0.91 +/- 0.15 vs. 0.93 +/- 0.12 g/cm(2) (diff 0.02, 95% CI +0.005, -0.045).
Conclusion
HIV+ women reported significantly more past osteoporotic fractures than population-based controls despite normal BMD. Research is needed to assess bone microarchitecture and develop a reliable fracture risk assessment tool for HIV+ women.
Prior JC HIV positive women bone mineral density fragility fractures, HIV women osteoporosis risk antiretroviral therapy bone health, fragility fractures normal BMD HIV positive women case-control, bone mineral density HIV seropositive women population-based study, antiretroviral therapy bone microarchitecture fracture risk assessment, HIV positive women oligomenorrhea menstrual disturbance bone loss, Canadian population-based osteoporosis study HIV women, bone density HIV women phantom-adjusted DXA comparison, fracture risk despite normal BMD HIV women Prior, case-control study HIV bone health Canadian women
PMID 17665239 17665239 DOI 10.1007/s00198-007-0428-7 10.1007/s00198-007-0428-7
Cite this article
Burdge, D. R., Maan, E., Burdge, D. R., Prior, J. C., Klein, M., Walmsley, S., & Prior, J. C. (2007). Fragility fractures and bone mineral density in HIV positive women: a case-control population-based study. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 18(10), 1345-1353. https://doi.org/10.1007/s00198-007-0428-7
Burdge DR, Maan E, Burdge DR, Prior JC, Klein M, Walmsley S, et al. Fragility fractures and bone mineral density in HIV positive women: a case-control population-based study. Osteoporos Int. 2007;18(10):1345-1353. doi:10.1007/s00198-007-0428-7
Burdge, David R., et al. "Fragility fractures and bone mineral density in HIV positive women: a case-control population-based study." Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 18, no. 10, 2007, pp. 1345-1353.
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