title: Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large U.S. healthcare system.
abstract: 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.
authors.affiliation: Program in Nutritional Metabolism, Massachusetts General Hospital, 55 Fruit Street, Longfellow 207, Boston, Massachusetts 02114. sgrinspoon@partners.org.
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Triant
authors.forename: Todd T
authors.initials: TT
authors.lastname: Brown
authors.forename: Hang
authors.initials: H
authors.lastname: Lee
authors.forename: Steven K
authors.initials: SK
authors.lastname: Grinspoon
mesh_terms: 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