Llop M, et al. - Experts ascertained the prevalence of asymptomatic vertebral fractures (VF) and related factors in HIV-infected patients over 50 years, and the role of FRAX equation. In HIV-infected patients older than 50 years, the prevalence of asymptomatic vertebral fractures was seen to be high. It was neither identified by the presence of osteoporosis in spine nor predicted by the FRAX equation. In this ageing population, spine and lumbar X-rays ought to be routinely performed.

Methods

• A diagnosis of VF was established by the semiquantitative method of Genant in thoracic and lumbar radiographs, in a cross-sectional study.
• Simultaneously, authors assessed a dual X-ray absorptiometry (DXA), bone and kidney-related analytical, calcium intake, physical exercise, HIV-related factors, and FRAX estimation.

Results

• As per data, overall, 128 patients (35 women, 27%) were included.
• Findings demonstrated that 57 years was the mean age.
• In 13 and 21%, hypophosphatemia and tubular renal dysfunction were observed.
• Results suggested that in 65 and 7% of patients DXA scan showed osteopenia and osteoporosis at hip and in spine in 39 and 34%, respectively.
• In 26 patients (20%) VF were observed, with a trend to be associated with lower serum phosphate, increased alkaline phosphatase, and with lower daily calcium intake.
• Reserarchers noted that in a multivariate analysis older age (OR 1.2 per year; 14% of VF at 50–55; 44% at 65–70), male sex (26 vs 6%), longer time since HIV diagnosis, and renal and tubular dysfunction were the associated factors.
• They found that at lumbar spine VF were not related with osteoporosis, and could not be predicted by the FRAX equation.