Antiretrovirals, Fractures, and Osteonecrosis in a Large International HIV Cohort

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11140%2F17%3A10359630" target="_blank" >RIV/00216208:11140/17:10359630 - isvavai.cz</a>

Výsledek na webu

<a href="https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cix167" target="_blank" >https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cix167</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/cid/cix167" target="_blank" >10.1093/cid/cix167</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Antiretrovirals, Fractures, and Osteonecrosis in a Large International HIV Cohort

Popis výsledku v původním jazyce

Background: Antiretrovirals (ARVs) affect bone density and turnover, but their effect on risk of fractures and osteonecrosis of the femoral head is less understood. We investigated if exposure to ARVs increases the risk of both bone outcomes. Methods: EuroSIDA participants were followed to assess fractures and osteonecrosis. Poisson regression identified clinical, laboratory and demographic predictors of either bone outcome. Ever, current and cumulative exposures to ARVs were assessed. . Results: During 86118 PYFU among 11820 included persons (median age 41y, 75% male, median baseline CD4 440/mm3, 70.4% virologically suppressed), there were 619 fractures (incidence/1000PYFU 7.2; 95%CI 6.6-7.7) and 89 osteonecrosis (1.0;0.8-1.3). Older age, white race, lower BMI, IV drug use, lower baseline CD4, HCV-coinfection, prior osteonecrosis, prior fracture, cardiovascular disease and recent non-AIDS cancer (last 12 months) were associated with fractures. After adjustment, persons who had ever used Tenofovir Disoproxil Fumarate (TDF) (1.40; 1.15-1.70) or who were currently on TDF (1.25; 1.05-1.49) had higher incidence of fractures. There was no association between cumulative exposure to TDF and fractures (1.08/5y exposure; 0.94-1.25). No other ARV was associated with fractures (all p&gt;0.1). Risk of osteonecrosis was associated with white race, lower nadir CD4, prior osteonecrosis, prior fracture and prior AIDS. After mutual adjustment, no ARV was associated with osteonecrosis.

Název v anglickém jazyce

Antiretrovirals, Fractures, and Osteonecrosis in a Large International HIV Cohort

Popis výsledku anglicky

Background: Antiretrovirals (ARVs) affect bone density and turnover, but their effect on risk of fractures and osteonecrosis of the femoral head is less understood. We investigated if exposure to ARVs increases the risk of both bone outcomes. Methods: EuroSIDA participants were followed to assess fractures and osteonecrosis. Poisson regression identified clinical, laboratory and demographic predictors of either bone outcome. Ever, current and cumulative exposures to ARVs were assessed. . Results: During 86118 PYFU among 11820 included persons (median age 41y, 75% male, median baseline CD4 440/mm3, 70.4% virologically suppressed), there were 619 fractures (incidence/1000PYFU 7.2; 95%CI 6.6-7.7) and 89 osteonecrosis (1.0;0.8-1.3). Older age, white race, lower BMI, IV drug use, lower baseline CD4, HCV-coinfection, prior osteonecrosis, prior fracture, cardiovascular disease and recent non-AIDS cancer (last 12 months) were associated with fractures. After adjustment, persons who had ever used Tenofovir Disoproxil Fumarate (TDF) (1.40; 1.15-1.70) or who were currently on TDF (1.25; 1.05-1.49) had higher incidence of fractures. There was no association between cumulative exposure to TDF and fractures (1.08/5y exposure; 0.94-1.25). No other ARV was associated with fractures (all p&gt;0.1). Risk of osteonecrosis was associated with white race, lower nadir CD4, prior osteonecrosis, prior fracture and prior AIDS. After mutual adjustment, no ARV was associated with osteonecrosis.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30303 - Infectious Diseases

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Clinical Infectious Diseases

ISSN

1058-4838

e-ISSN

—

Svazek periodika

64

Číslo periodika v rámci svazku

10

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

9

Strana od-do

1413-1421

Kód UT WoS článku

000400912500017

EID výsledku v databázi Scopus

2-s2.0-85019104735