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Article
Increased risk of fragility fractures among HIV infected compared to uninfected male veterans
Women’s Health Research Faculty Publications
  • Julie Womack, VA Connecticut Health Care System
  • Joseph Goulet, Yale University
  • Cynthia Gibert, George Washington University - School of Medicine and Health Sciences
  • Cynthia Brandt, Yale University
  • Chung Chou Chang, University of Pittsburgh - Main Campus
  • Barbara Gulanski, Yale University
  • Liana Fraenkel, Yale University
  • Kristin M. Mattocks, University of Massachusetts Medical School Worcester
  • David Rimland, Emory University
  • Maria Rodriguez-Barradas, Baylor College of Medicine
  • Janet Tate, Veterans Affairs Connecticut Healthcare System
  • Michael T. Yin, Columbia University
  • Amy Justice, Yale University
UMMS Affiliation
Department of Quantitative Health Sciences
Date
2-1-2011
Document Type
Article
Subjects
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
Abstract

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/m(2); 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.

Rights and Permissions
Citation: PLoS One. 2011 Feb 16;6(2):e17217. doi: 10.1371/journal.pone.0017217. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
21359191
Citation Information
Julie Womack, Joseph Goulet, Cynthia Gibert, Cynthia Brandt, et al.. "Increased risk of fragility fractures among HIV infected compared to uninfected male veterans" Vol. 6 Iss. 2 (2011) ISSN: 1932-6203 (Linking)
Available at: http://works.bepress.com/kristin_mattocks/25/