Low bone mineral density and fracture risk in HIV infection

Low bone mineral density has been strongly linked to an increased risk of fracture in HIV-uninfected older men and women. Although multiple cross-sectional studies have demonstrated that HIV-infected patients have lower bone mineral density than HIV-uninfected persons, the mechanisms for this difference and its clinical significance remain unclear. To address the clinical implications, Triant and colleagues performed a retrospective review of more than 2 million patients in the Partners Healthcare system, comparing fracture prevalence among HIV-infected and -uninfected patients. Patients with HIV had more fractures than uninfected patients and, although this analysis did not adjust for known risk factors for osteoporosis, this study is the first to demonstrate a significantly increased risk of fracture in HIV-infected patients.