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Increased risk of fragility fractures among HIV infected compared to uninfected male veterans.

Womack, Julie A and Goulet, Joseph L and Gibert, Cynthia and Brandt, Cynthia and Chang, Chung Chou and Gulanski, Barbara and Fraenkel, Liana and Mattocks, Kristin and Rimland, David and Rodriguez-Barradas, Maria C and Tate, Janet and Yin, Michael T and Justice, Amy C and Veterans Aging Cohort Study Project Team, (2011) Increased risk of fragility fractures among HIV infected compared to uninfected male veterans. PLoS One, 6 (2). e17217 - ?.

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BACKGROUND: HIV infection has been associated with an increased risk of fragility fracture. We explored whether or not this increased risk persisted in HIV infected and uninfected men when controlling for traditional fragility fracture risk factors. METHODOLOGY/PRINCIPAL FINDINGS: Cox regression models were used to assess the association of HIV infection with the risk for incident hip, vertebral, or upper arm fracture in male Veterans enrolled in the Veterans Aging Cohort Study Virtual Cohort (VACS-VC). We calculated adjusted hazard ratios comparing HIV status and controlling for demographics and other established risk factors. The sample consisted of 119,318 men, 33% of whom were HIV infected (34% aged 50 years or older at baseline, and 55% black or Hispanic). Median body mass index (BMI) was lower in HIV infected compared with uninfected men (25 vs. 28 kg/m²; p<0.0001). Unadjusted risk for fracture was higher among HIV infected compared with uninfected men [HR: 1.32 (95% CI: 1.20, 1.47)]. After adjusting for demographics, comorbid disease, smoking and alcohol abuse, HIV infection remained associated with an increased fracture risk [HR: 1.24 (95% CI: 1.11, 1.39)]. However, adjusting for BMI attenuated this association [HR: 1.10 (95% CI: 0.97, 1.25)]. The only HIV-specific factor associated with fragility fracture was current protease inhibitor use [HR: 1.41 (95% CI: 1.16, 1.70)]. CONCLUSIONS/SIGNIFICANCE: HIV infection is associated with fragility fracture risk. This risk is attenuated by BMI.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Womack, Julie A
Goulet, Joseph L
Gibert, Cynthia
Brandt, Cynthia
Chang, Chung Chouchangj@pitt.eduCHANGJ
Gulanski, Barbara
Fraenkel, Liana
Mattocks, Kristin
Rimland, David
Rodriguez-Barradas, Maria C
Tate, Janet
Yin, Michael T
Justice, Amy C
Veterans Aging Cohort Study Project Team,
Date: 26 January 2011
Date Type: Acceptance
Journal or Publication Title: PLoS One
Volume: 6
Number: 2
Page Range: e17217 - ?
DOI or Unique Handle: 10.1371/journal.pone.0017217
Refereed: Yes
Uncontrolled Keywords: Aged, Aged, 80 and over, Bone Density, Follow-Up Studies, Fractures, Bone, HIV Infections, HIV-1, Humans, Male, Middle Aged, Osteoporosis, Risk Factors, Sex Characteristics, Veterans
Funders: NINR NIH HHS (K01 NR013437), NIAID NIH HHS (K23 AI059884), NIAAA NIH HHS (U10 AA013566), NIAAA NIH HHS (U10 AA 13566)
MeSH Headings: Aged; Aged, 80 and over; Bone Density--physiology; Follow-Up Studies; Fractures, Bone--epidemiology; Fractures, Bone--etiology; HIV Infections--complications; HIV Infections--epidemiology; HIV-1--physiology; Humans; Male; Middle Aged; Osteoporosis--complications; Osteoporosis--epidemiology; Risk Factors; Sex Characteristics; Veterans--statistics & numerical data
Other ID: NLM PMC3040233
PubMed Central ID: PMC3040233
PubMed ID: 21359191
Date Deposited: 07 Aug 2012 15:45
Last Modified: 20 Oct 2017 23:55


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