Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large U.S. healthcare system.
BACKGROUND
Reduced bone mineral density has been demonstrated among HIV-infected patients, but fracture prevalence is unknown.


OBJECTIVE
The objective of the study was to compare fracture prevalence in HIV-infected and non-HIV-infected patients.


METHODS
This was a population-based study.


METHODS
The study was conducted at a large U.S. health care system.


METHODS
A total of 8525 HIV-infected and 2,208,792 non-HIV-infected patients with at least one inpatient or outpatient encounter between October 1, 1996, and March 21, 2008, was compared.


METHODS
Fracture prevalence using specific International Classification of Diseases, Ninth Revision, Clinical Modification fracture codes was measured.


RESULTS
The overall fracture prevalence was 2.87 vs. 1.77 patients with fractures per 100 persons in HIV-infected, compared with non-HIV-infected patients (P < 0.0001). Among females, the overall fracture prevalence was 2.49 vs. 1.72 per 100 persons in HIV-infected vs. non-HIV-infected patients (P = 0.002). HIV-infected females had a higher prevalence of vertebral (0.81 vs. 0.45; P = 0.01) and wrist (1.31 vs. 0.83; P = 0.01) fractures per 100 persons, compared with non-HIV-infected females but had a similar prevalence of hip fractures (0.47 vs. 0.56; P = 0.53). Among males, the fracture prevalence per 100 persons was higher in HIV-infected vs. non-HIV-infected patients for any fracture (3.08 vs. 1.83; P < 0.0001), vertebral fractures (1.03 vs. 0.49; P < 0.0001), hip fractures (0.79 vs. 0.45; P = 0.001), and wrist fractures (1.46 vs. 0.99; P = 0.001). Fracture prevalence was higher relative to non-HIV-infected patients among African-American and Caucasian females and Caucasian males.


CONCLUSIONS
Fracture prevalence is increased in HIV-infected compared with non-HIV-infected patients.
Triant
Virginia A
VA
Program in Nutritional Metabolism, Massachusetts General Hospital, 55 Fruit Street, Longfellow 207, Boston, Massachusetts 02114. sgrinspoon@partners.org.
Brown
Todd T
TT
Lee
Hang
H
Grinspoon
Steven K
SK
D000328:Adult; D000368:Aged; D003695:Delivery of Health Care; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D014481:United States