on these findings, the researchers concluded, "Age-adjusted
fracture rates among HOPS patients were higher than rates in the
general U.S. population during the period 2000-2006."
should regularly assess HIV-infected persons for fracture risk,
especially those with low nadir CD4 cell counts or other established
risk factors for fracture," they recommended.
believe that our analysis is the first to highlight a possible
association of low nadir CD4 cell count with incident fracture
rates," they stated in their discussion. "The causal
mechanism by which low nadir CD4 cell count is associated with
low [bone mineral density] and fracture risk is unclear and warrants
optimal clinical management of bone health in HIV-infected individuals
is not well defined and remains controversial," Young said
in a press release issued by the Infectious Diseases Society of
America, which publishes Clinical Infectious Diseases.
believe our data support the need to develop guidelines that address
screening for and correcting reversible causes of low bone mineral
density and fall risk and that these activities should be incorporated
into the routine care of HIV-infected patients," he added.
past fall an international team of HIV experts reviewed recent
research on bone problems in people with HIV and developed
a set of recommendations. All HIV positive women who have
reached menopause and HIV positive men age 50 or older should
undergo DEXA bone density screening, they advised. To prevent
bone problems, patients should take calcium and vitamin D supplements,
get adequate sun exposure, and exercise regularly.
that their findings suggest that younger HIV positive adults are
also at significant risk for fragility fractures, Young and colleagues
recommended that they too "should be considered for similar
affiliations: Rocky Mountain Center for AIDS Research, Education,
and Services/DIDC, Denver, CO; Division of HIV/AIDS Prevention,
Centers for Disease Control and Prevention, Atlanta, GA; Cerner,
Vienna, VA; Health Connections International, Amsterdam, Netherlands.
Young, CN Dao, K Buchacz, et al (HIV Outpatient Study Investigators).
Increased Rates of Bone Fracture among HIV-infected Persons in
the HIV Outpatient Study (HOPS) Compared with the US General Population,
2000-2006. Clinical Infectious Diseases (free
full text) March 10, 2011 (Epub ahead of print).
Diseases Society of America. Research suggests HIV-infected patients
at higher risk for bone fractures. Press release. March 11, 2011.