title: Prevalence of sub-clinical vertebral fractures in HIV-infected patients.
abstract: Although the increased prevalence of low bone mineral density among HIV-infected patients has raised concern for increased fracture risk, few investigations have evaluated fracture rates. Increasing evidence indicates that HIV patients are at higher risk of osteoporotic fractures compared to the general population. This is a very important issue, because fragility fractures are complications with a significant prognostic value. Our study performed lateral spine X-ray to assess the prevalence of sub-clinical vertebral fractures in 202 HIV patients. Factors associated with vertebral fractures were also investigated. The prevalence of vertebral fractures was significantly high (23.3%): 14 subjects had SDI (spine deformity index)= 1, 22 SDI=2-3 and 11 SDI >4. Differences in the prevalence of vertebral fractures between naive and ART experienced patients was 18% vs. 24%, respectively. Furthermore, patients had a high prevalence of severe and multiple fractures; in 19 patients (40%) fractures involved multiple vertebrae. Patients with vertebral fractures were significantly older, with renal insufficiency and steroid use more frequently than subjects with no fractures. Our data suggest that the prevalence of vertebral fractures in HIV infection may be higher than expected, and lateral spine X-ray has a role in the screening of bone disease, at least in patients with a significant risk of fragility fractures.
authors: Infectious Disease Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors: Marco
authors: M
authors: Borderi
authors: Leonardo
authors: L
authors: Calza
authors: Vincenzo
authors: V
authors: Colangeli
authors: Elisa
authors: E
authors: Vanino
authors: Pierluigi
authors: P
authors: Viale
authors: Davide
authors: D
authors: Gibellini
authors: Maria Carla
authors: MC
authors: Re
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D013131:Spine / Q000000981:diagnostic imaging