title: Use of dual-energy x-ray absorptiometry (DXA) scans in HIV-infected patients.
abstract: Multiple studies have demonstrated increased rates of osteopenia and osteoporosis in HIV-infected patients but there have been no published studies on current screening practices. We conducted a retrospective chart review of 2924 patients attending an urban HIV clinic. Thirty patients (1%) had dual-energy x-ray absorptiometry (DXA) scans. Patients undergoing DXA scans were more likely to be older, women, and have nondetectable HIV viral load and CD4 count ≥200. The most frequently cited indications for screening were perimenopausal or postmenopausal status and HIV infection. Of the patients screened, 96% had osteopenia or osteoporosis with a median T-score of -1.9 and a median of 3.8 osteoporosis risk factors in addition to HIV.  Of the 20 practitioners in the clinic, only 7 had patients with screening DXA scans. DXA scans are underutilized in the HIV population given the high rate of osteopenia and osteoporosis detected in this study.
authors.affiliation: 1University of Maryland Medical Center, Internal Medicine, Baltimore, MD, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Dickinson
authors.forename: L E
authors.initials: LE
authors.lastname: Fantry
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D019380:Anti-HIV Agents / Q000009:adverse effects; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis*; D047648:Perimenopause; D017698:Postmenopause; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking
chemical_list: D019380:Anti-HIV Agents