Osteonecrosis in patients with human immunodeficiency virus type 1 infection in Taiwan

Ya Chi Ho, Tiffany T.F. Shih, Yu Hui Lin, Chin Fu Hsiao, Mao Yuan Chen, Szu Min Hsieh, Wang Huei Sheng, Hsin Yun Sun, Chien Ching Hung, Shan Chwen Chang

Research output: Contribution to journalArticle

Abstract

Osteonecrosis, a disabling complication associated with antiretroviral therapy (ART) and human immunodeficiency virus (HM infection, has rarely been reported in an Asian population. After an observation of 3,250 person-years (PY), 11 of 967 (1.1%) HIV-infected patients at a median age of 34 years developed osteonecrosis involving the hip joints (incidence, 3.4 per 1,000 PY). Their median CD4+ lymphocyte count had increased from 35 cells/μL at the diagnosis of IRV infection to 297 cells/μL at the diagnosis of osteonecrosis. The crude rate of osteonecrosis increased from 0% in patients without exposure to ART to 2.6 and 1.7% in patients with exposure to nucleoside reverse transcriptase inhibitors (NRTIs) and who had undergone highly active antiretroviral therapy (HAART) for 5 years or longer, respectively (P = 0.18 and 0.09, respectively). Among the patients receiving HAART, the estimated incidence of osteonecrosis was 4.2 per 1,000 PY. Patients with osteonecrosis had a longer duration of exposure to NRTls (1,641 versus 1,264 days, P = 0.26) and to HAART (1,603 versus 1,251 days, P = 0.42), a higher serum triglyceride (median, 1,130 versus 351 mg/dl; P = 0.09), and a higher proportion of lipodystrophy (81.8 versus 15.0%, P < 0.0001). Our report suggests that osteonecrosis is a rare complication in HIV-infected patients with prolonged exposure to ART with resultant metabolic complications.

Original languageEnglish (US)
Pages (from-to)382-386
Number of pages5
JournalJapanese Journal of Infectious Diseases
Volume60
Issue number6
StatePublished - Dec 4 2007

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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    Ho, Y. C., Shih, T. T. F., Lin, Y. H., Hsiao, C. F., Chen, M. Y., Hsieh, S. M., Sheng, W. H., Sun, H. Y., Hung, C. C., & Chang, S. C. (2007). Osteonecrosis in patients with human immunodeficiency virus type 1 infection in Taiwan. Japanese Journal of Infectious Diseases, 60(6), 382-386.