title: Antiretroviral treatment and osteonecrosis in patients of the Swiss HIV Cohort Study: a nested case-control study.
abstract: We examined risk factors for avascular bone necrosis (AVN) particularly focusing o the question of whether antiretroviral treatment (ART) is associated with the emergence of osteonecrosis. After 11 years of following the entire cohort, 26 patients were found to have AVN. Compared to 260 concurrent HIV-infected controls, at risk when cases were diagnosed, patients with AVN had lower CD4 cell count nadirs (median 86.5 versus 137.5 cells/microl, p = 0.010) and suffered significantly more often from Pneumocystis pneumonia, cerebral toxoplasmosis, CMV retinitis, and atypical mycobacteriosis and had a significantly higher body mass index than controls. Duration of ART before AVN was not significantly different between cases and controls (2.92 versus 2.17 years, p = 0.30). In conclusion, AVN could not be attributed to time on antiretroviral treatment, but patients with AVN had histories of more severe immunosuppression and a higher body mass index than controls.
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hasse
authors.forename: Bruno
authors.initials: B
authors.lastname: Ledergerber
authors.forename: Matthias
authors.initials: M
authors.lastname: Egger
authors.forename: Markus
authors.initials: M
authors.lastname: Flepp
authors.forename: Stefano
authors.initials: S
authors.lastname: Bachmann
authors.forename: Enos
authors.initials: E
authors.lastname: Bernasconi
authors.forename: Martin
authors.initials: M
authors.lastname: Egger
authors.forename: Sophie
authors.initials: S
authors.lastname: Guyot
authors.forename: Bernard
authors.initials: B
authors.lastname: Hirschel
authors.forename: Rainer
authors.initials: R
authors.lastname: Weber
authors.forename: Huldrych F
authors.initials: HF
authors.lastname: Günthard
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1; D006801:Humans; D015994:Incidence; D008297:Male; D010020:Osteonecrosis / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents