An increased rate of fracture occurs a decade earlier in HIV+ compared with HIV-men

Anda Gonciulea, Ruibin Wang, Keri N. Althoff, Frank J. Palella, Jordan Lake, Lawrence A. Kingsley, Todd T. Brown*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


Objectives: To determine the incidence of fracture among aging HIV-infected (HIV+) and uninfected men (HIV-). To evaluate factors independently associated with fracture risk. Design: Prospective, multicenter cohort study of men with or at risk for HIV. Methods: Outcome measures: all fractures (excluding skull, face and digits) and fragility fractures (vertebral column, femur, wrist and humerus) were collected semiannually in 1221 HIV+ and 1408 HIV-men aged at least 40. Adjusted incident rate ratios (aIRR) with an interaction term for age (40-49, 50-59 and ≥60 years) and HIV serostatus were estimated with Poisson regression models accounting for additional risk factors. Results: Fracture incidence increased with age among both HIV+ and HIV-men. Although there was no significant difference in fracture incidence by HIV serostatus among men aged 40-49 years, the HIV+ men aged 50-59 years had a significantly higher incidence of all fractures [aIRR: 2.06 (1.49, 2.84)] and fragility fractures [aIRR: 2.06 (1.21, 3.50)] compared with HIV-participants of similar age. HIV modified the effect of age on all fractures (P = 0.002) but did not significantly modify the effect for fragility fractures (P = 0.135). Hypertension increased the rate of all fractures by 32% after adjustment for covariates [aIRR: 1.32 (1.04, 1.69)]. Conclusion: Fracture incidence increased with age among HIV+ and HIV-men but was higher among HIV+ men. A significant increase in fracture incidence was found among 50-59-year-old HIV+ men, highlighting the importance of osteoporosis screening for HIV-infected men above the age of 50.

Original languageEnglish (US)
Pages (from-to)1435-1443
Number of pages9
Issue number10
StatePublished - Jun 19 2017


  • HIV
  • antiretroviral therapy
  • fracture
  • fragility fracture
  • osteoporosis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


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