ArticlePloS one2013
A cross-sectional randomised study of fracture risk in people with HIV infection in the probono 1 study.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- People with HIV infection had lower bone mineral density and increased fracture risk: a meta-analysis.Archives of osteoporosis · 2021Pooled it
- Bone fracture among people living with HIV: A systematic review and meta-regression of prevalence, incidence, and risk factors.PloS one · 2020Pooled it
- People living with HIV and fracture risk.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Review
- The Hidden Burden of Fractures in People Living With HIV.JBMR plus · 2018Review
- HIV and ageing: improving quantity and quality of life.Current opinion in HIV and AIDS · 2016Review
- Does systemic inflammation and immune activation contribute to fracture risk in HIV?Current opinion in HIV and AIDS · 2016Review
- Bone alterations associated with HIV.Current HIV/AIDS reports · 2014Article
- Do the rates we report misinform the local programs?Pakistan journal of medical sciences · 2014Article
- Osteoporosis in Human Immunodeficiency Virus Patients - An Emerging Clinical Concern.European endocrinology · 2014Review
- Making sense of how HIV kills infected CD4 T cells: implications for HIV cure.Molecular and cellular therapies · 2014Review
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo determine comparative fracture risk in HIV patients compared with uninfected controls.
designA randomised cross-sectional study assessing bone mineral density (BMD), fracture history and risk factors in the 2 groups.
settingHospital Outpatients. SUBBBJECTS: 222 HIV infected patients and an equal number of age-matched controls. ASSESSMENTS: Fracture risk factors were assessed and biochemical, endocrine and bone markers measured. BMD was assessed at hip and spine. 10-year fracture probability (FRAX) and remaining lifetime fracture probability (RFLP) were calculated.
main outcome measuresBMD, and history of fractures.
resultsReported fractures occurred more frequently in HIV than controls, (45 vs. 16; 20.3 vs. 7%; OR=3.27; p=0.0001), and unsurprisingly in this age range, non-fragility fractures in men substantially contributed to this increase. Osteoporosis was more prevalent in patients with HIV (17.6% vs. 3.6%, p<0.0001). BMD was most reduced, and predicted fracture rates most increased, at the spine. Low BMD was associated with antiretroviral therapy (ART), low body mass index and PTH. 10-year FRAX risk was <5% for all groups. RLFP was greater in patients with HIV (OR=1.22; p=0.003) and increased with ART (2.4 vs. 1.50; OR= 1.50; p=0.03).
conclusionsThe increased fracture rate in HIV patients in our relatively youthful population is partly driven by fractures, including non-fragility fractures, in men. Nonetheless, these findings may herald a rise in osteoporotic fractures in HIV patients. An appropriate screening and management response is required to assess these risks and identify associated lifestyle factors that are also associated with other conditions such as cardiovascular disease and diabetes.
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