ArticleArchives of osteoporosis2021
Incident bone fracture and mortality in a large HIV cohort outpatient study, 2000-2017, USA.
Article in Archives of osteoporosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Incidence of frailty-related fracture among Medicaid beneficiaries living with HIV and cancer: A cohort study.PloS one · 2026Article
- Incidence of frailty-related fracture among Medicaid beneficiaries living with HIV and cancer: A cohort study.medRxiv : the preprint server for health sciences · 2025Article
- Prevalence and associated factors of low bone mineral density in people living with HIV: a cross-sectional study.Archives of osteoporosis · 2024Article
- Bone Disease in HIV: Need for Early Diagnosis and Prevention.Life (Basel, Switzerland) · 2024Review
- Alcohol and falls among people with HIV infection: A view from Russia and the United States.Alcoholism, clinical and experimental research · 2022Article
- Osteoporosis and HIV Infection.Calcified tissue international · 2022Review
- Study Protocol for a Pilot Randomized Trial of a Virtual Occupational Therapy Fall Prevention Intervention for People With HIV and Alcohol Use.Substance abuse : research and treatment · 2022Article
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Authors and funding
12 authors at 7 institutions in 1 country.
Funding
Abstract
We evaluated the association of bone fracture with mortality among persons with HIV, controlling for sociodemographic, behavioral, and clinical factors. Incident fracture was associated with 48% greater risk of all-cause mortality, underscoring the need for bone mineral density screening and fracture prevention. PURPOSE/
introductionLow bone mineral density (BMD) and fracture are more common among persons with HIV (PWH) than those without HIV infection. We evaluated the association of bone fracture with mortality among PWH, controlling for sociodemographic, behavioral, and clinical factors.
methodsWe analyzed data from HIV Outpatient Study (HOPS) participants seen at nine US HIV clinics during January 1, 2000, through September 30, 2017. Incident fracture rates and post-fracture mortality were compared across four calendar periods. Cox proportional hazards analyses determined factors associated with all-cause mortality among all participants and those with incident fracture.
resultsAmong 6763 HOPS participants, 504 (7.5%) had incident fracture (median age = 47 years) and 719 (10.6%) died. Of fractures, 135 (26.8%) were major osteoporotic (hip/pelvis, wrist, spine, arm/shoulder). During observation, 27 participants with major osteoporotic fractures died (crude mortality 2.97/100 person-years [PY]), and 48 with other site fractures died (crude mortality 2.51/100 PY). Post-fracture, age- and sex-adjusted all-cause mortality rates per 100 PY decreased from 8.5 during 2000-2004 to 1.9 during 2013-2017 (P<0.001 for trend). In multivariable analysis, incident fracture was significantly associated with all-cause mortality (Hazard Ratio 1.48, 95% confidence interval 1.15-1.91). Among 504 participants followed post-fracture, pulmonary, kidney, and cardiovascular disease, hepatitis C virus co-infection, and non-AIDS cancer, remained independently associated with all-cause mortality.
conclusionsIncident fracture was associated with 48% greater risk of all-cause mortality among US PWH in care, underscoring the need for BMD screening and fracture prevention. Although fracture rates among PWH increased during follow-up, post-fracture death rates decreased, likely reflecting advances in HIV care.
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