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Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV

SUMMARY: Osteoporosis and fracture risk among women with HIV in Latin America is understudied. In a sample of Peruvian women with and without HIV, women with HIV had lower femoral neck and total hip BMD and a higher proportion of vertebral fractures. Important treatment gaps were identified across b...

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Autores principales: Cabrera, Diego M., Cornejo, Mijahil P., Slotkin, Rebecca, Pinedo, Yvett, Yu, Wei, Guan, Wenmin, Garcia, Patricia J., Hsieh, Evelyn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170032/
https://www.ncbi.nlm.nih.gov/pubmed/37160770
http://dx.doi.org/10.1007/s11657-023-01250-w
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author Cabrera, Diego M.
Cornejo, Mijahil P.
Slotkin, Rebecca
Pinedo, Yvett
Yu, Wei
Guan, Wenmin
Garcia, Patricia J.
Hsieh, Evelyn
author_facet Cabrera, Diego M.
Cornejo, Mijahil P.
Slotkin, Rebecca
Pinedo, Yvett
Yu, Wei
Guan, Wenmin
Garcia, Patricia J.
Hsieh, Evelyn
author_sort Cabrera, Diego M.
collection PubMed
description SUMMARY: Osteoporosis and fracture risk among women with HIV in Latin America is understudied. In a sample of Peruvian women with and without HIV, women with HIV had lower femoral neck and total hip BMD and a higher proportion of vertebral fractures. Important treatment gaps were identified across both groups. PURPOSE: Studies have shown that patients with HIV are at increased risk for bone loss and fracture due to a combination of host, viral, and antiretroviral therapy (ART)-related factors. We aimed to explore the prevalence of vertebral fracture (VF) and low bone mineral density (BMD) among women aging with HIV in Peru and identify risk factors for osteoporosis and fracture in this population. METHODS: We enrolled women living with and without HIV aged ≥40 years between 2019 and 2020. Participants completed a survey and obtained dual X-ray absorptiometry (DXA) test to assess BMD at the lumbar spine (LS), femoral neck (FN), and total hip (TH). A subset of patients also obtained lateral thoracolumbar X-rays. Presence of VF was determined using the Genant semiquantitative method. Regression analyses were used to model associations between key risk factors and BMD. RESULTS: 104 women living with HIV and 212 women living without HIV were enrolled with a mean age of 52.4±8.2 and 56.4±8.8 years (p < 0.001). Among postmenopausal women (257/316, 81.3%), 26.3% of women living with HIV and 25.9% of those without HIV had osteoporosis. Among the 88 women living with HIV and 178 women living without HIV who obtained thoracolumbar X-rays, 12.5% and 6.2%, respectively, had at least one VF. Based on DXA and the FRAX score, 22/104 women living with HIV met criteria for osteoporosis treatment according to national guidelines; however, none were on treatment. Propensity score matching revealed that women living with HIV had 0.032 g/cm(2) lower FN BMD (p = 0.012) and 0.034 g/cm(2) lower TH BMD (p = 0.041) compared to women without HIV. CONCLUSION: In this study, women living with HIV on long-standing ART had increased VF prevalence compared to the slightly older group of women without HIV. Age and BMI were independent predictors for BMD at the lumbar spine, hip, and femoral neck among women living with HIV, and there was a treatment gap among women who met criteria for osteoporosis treatment. Larger studies are needed in this region to identify individuals at risk for fracture and to inform prevention guidelines.
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spelling pubmed-101700322023-05-11 Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV Cabrera, Diego M. Cornejo, Mijahil P. Slotkin, Rebecca Pinedo, Yvett Yu, Wei Guan, Wenmin Garcia, Patricia J. Hsieh, Evelyn Arch Osteoporos Original Article SUMMARY: Osteoporosis and fracture risk among women with HIV in Latin America is understudied. In a sample of Peruvian women with and without HIV, women with HIV had lower femoral neck and total hip BMD and a higher proportion of vertebral fractures. Important treatment gaps were identified across both groups. PURPOSE: Studies have shown that patients with HIV are at increased risk for bone loss and fracture due to a combination of host, viral, and antiretroviral therapy (ART)-related factors. We aimed to explore the prevalence of vertebral fracture (VF) and low bone mineral density (BMD) among women aging with HIV in Peru and identify risk factors for osteoporosis and fracture in this population. METHODS: We enrolled women living with and without HIV aged ≥40 years between 2019 and 2020. Participants completed a survey and obtained dual X-ray absorptiometry (DXA) test to assess BMD at the lumbar spine (LS), femoral neck (FN), and total hip (TH). A subset of patients also obtained lateral thoracolumbar X-rays. Presence of VF was determined using the Genant semiquantitative method. Regression analyses were used to model associations between key risk factors and BMD. RESULTS: 104 women living with HIV and 212 women living without HIV were enrolled with a mean age of 52.4±8.2 and 56.4±8.8 years (p < 0.001). Among postmenopausal women (257/316, 81.3%), 26.3% of women living with HIV and 25.9% of those without HIV had osteoporosis. Among the 88 women living with HIV and 178 women living without HIV who obtained thoracolumbar X-rays, 12.5% and 6.2%, respectively, had at least one VF. Based on DXA and the FRAX score, 22/104 women living with HIV met criteria for osteoporosis treatment according to national guidelines; however, none were on treatment. Propensity score matching revealed that women living with HIV had 0.032 g/cm(2) lower FN BMD (p = 0.012) and 0.034 g/cm(2) lower TH BMD (p = 0.041) compared to women without HIV. CONCLUSION: In this study, women living with HIV on long-standing ART had increased VF prevalence compared to the slightly older group of women without HIV. Age and BMI were independent predictors for BMD at the lumbar spine, hip, and femoral neck among women living with HIV, and there was a treatment gap among women who met criteria for osteoporosis treatment. Larger studies are needed in this region to identify individuals at risk for fracture and to inform prevention guidelines. Springer London 2023-05-10 2023 /pmc/articles/PMC10170032/ /pubmed/37160770 http://dx.doi.org/10.1007/s11657-023-01250-w Text en © International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Cabrera, Diego M.
Cornejo, Mijahil P.
Slotkin, Rebecca
Pinedo, Yvett
Yu, Wei
Guan, Wenmin
Garcia, Patricia J.
Hsieh, Evelyn
Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV
title Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV
title_full Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV
title_fullStr Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV
title_full_unstemmed Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV
title_short Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV
title_sort prevalence of and risk factors for vertebral fracture and low bone mineral density among peruvian women aging with hiv
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170032/
https://www.ncbi.nlm.nih.gov/pubmed/37160770
http://dx.doi.org/10.1007/s11657-023-01250-w
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