@article{1cc4deb829714d68b70728b34c8b9f78,
title = "An increased rate of fracture occurs a decade earlier in HIV+ compared with HIV-men",
abstract = "Objectives: To determine the incidence of fracture among aging HIV-infected (HIV+) and uninfected men (HIV-). To evaluate factors independently associated with fracture risk. Design: Prospective, multicenter cohort study of men with or at risk for HIV. Methods: Outcome measures: all fractures (excluding skull, face and digits) and fragility fractures (vertebral column, femur, wrist and humerus) were collected semiannually in 1221 HIV+ and 1408 HIV-men aged at least 40. Adjusted incident rate ratios (aIRR) with an interaction term for age (40-49, 50-59 and ≥60 years) and HIV serostatus were estimated with Poisson regression models accounting for additional risk factors. Results: Fracture incidence increased with age among both HIV+ and HIV-men. Although there was no significant difference in fracture incidence by HIV serostatus among men aged 40-49 years, the HIV+ men aged 50-59 years had a significantly higher incidence of all fractures [aIRR: 2.06 (1.49, 2.84)] and fragility fractures [aIRR: 2.06 (1.21, 3.50)] compared with HIV-participants of similar age. HIV modified the effect of age on all fractures (P = 0.002) but did not significantly modify the effect for fragility fractures (P = 0.135). Hypertension increased the rate of all fractures by 32% after adjustment for covariates [aIRR: 1.32 (1.04, 1.69)]. Conclusion: Fracture incidence increased with age among HIV+ and HIV-men but was higher among HIV+ men. A significant increase in fracture incidence was found among 50-59-year-old HIV+ men, highlighting the importance of osteoporosis screening for HIV-infected men above the age of 50.",
keywords = "HIV, antiretroviral therapy, fracture, fragility fracture, osteoporosis",
author = "Anda Gonciulea and Ruibin Wang and Althoff, {Keri N.} and Palella, {Frank J.} and Jordan Lake and Kingsley, {Lawrence A.} and Brown, {Todd T.}",
note = "Funding Information: Sources of funding: J.E.L. has received funding from the National Institutes of Health, National Institute of Allergy and Infectious Diseases (K23 AI110532). T.T.B. has received funding from the National Institutes of Health, National Institute of Allergy and Infectious Diseases (K24 AI120834 and R01AI093520). A.G. received support from the Clinical Research and Epidemiology in Diabetes and Endocrinology Training Grant T32DK062707. K.N.A. has received funding from the National Institutes of Health, National Institute of Allergy and Infectious Diseases (K01AI093197). Data in this article were collected by the Multicenter AIDS Cohort Study (MACS). MACS (Principal Investigators): Johns Hopkins University Bloomberg School of Public Health (Joseph Margolick), U01-AI35042; Northwestern University (Steven Wolinsky), U01-AI35039; University of California, Los Angeles (Roger Detels), U01-AI35040; University of Pittsburgh (Charles Rinaldo), U01-AI35041; the Center for Analysis and Management of MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson), UM1-AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional cofunding from the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute on Deafness and Communication Disorders (NIDCD). MACS data collection is also supported by UL1-TR001079 (JHU ICTR) from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The research was also supported by the HIV Prevention Trials Network (HPTN) sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute on Drug Abuse (NIDA), the National Institute of Mental Health (NIMH), and the Office of AIDS Research, of the National Institutes of Health (NIH), Dept. of Health and Human Services (DHHS) (UM1 AI068613). Publisher Copyright: Copyright {\textcopyright} 2017 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2017",
month = jun,
day = "19",
doi = "10.1097/QAD.0000000000001493",
language = "English (US)",
volume = "31",
pages = "1435--1443",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "10",
}