Osteonecrosis in patients with human immunodeficiency virus type 1 infection in Taiwan
Journal
Japanese Journal of Infectious Diseases
Journal Volume
60
Journal Issue
6
Pages
382-386
Date Issued
2007
Author(s)
Ho Y.-C.
Lin Y.-H.
Hsiao C.-F.
Chen M.-Y.
Abstract
Osteonecrosis, a disabling complication associated with antiretroviral therapy (ART) and human immunodeficiency virus (HM infection, has rarely been reported in an Asian population. After an observation of 3,250 person-years (PY), 11 of 967 (1.1%) HIV-infected patients at a median age of 34 years developed osteonecrosis involving the hip joints (incidence, 3.4 per 1,000 PY). Their median CD4+ lymphocyte count had increased from 35 cells/μL at the diagnosis of IRV infection to 297 cells/μL at the diagnosis of osteonecrosis. The crude rate of osteonecrosis increased from 0% in patients without exposure to ART to 2.6 and 1.7% in patients with exposure to nucleoside reverse transcriptase inhibitors (NRTIs) and who had undergone highly active antiretroviral therapy (HAART) for 5 years or longer, respectively (P = 0.18 and 0.09, respectively). Among the patients receiving HAART, the estimated incidence of osteonecrosis was 4.2 per 1,000 PY. Patients with osteonecrosis had a longer duration of exposure to NRTls (1,641 versus 1,264 days, P = 0.26) and to HAART (1,603 versus 1,251 days, P = 0.42), a higher serum triglyceride (median, 1,130 versus 351 mg/dl; P = 0.09), and a higher proportion of lipodystrophy (81.8 versus 15.0%, P < 0.0001). Our report suggests that osteonecrosis is a rare complication in HIV-infected patients with prolonged exposure to ART with resultant metabolic complications.
SDGs
Other Subjects
alendronic acid; proteinase inhibitor; RNA directed DNA polymerase inhibitor; triacylglycerol; adolescent; adult; article; bone density; bone necrosis; CD4+ T lymphocyte; clinical article; controlled study; disease association; drug exposure; dual energy X ray absorptiometry; female; highly active antiretroviral therapy; hip; HIV associated lipodystrophy; human; Human immunodeficiency virus 1; Human immunodeficiency virus 1 infection; incidence; joint radiography; long term care; lymphocyte count; male; nuclear magnetic resonance imaging; Taiwan; total hip prosthesis; treatment duration; triacylglycerol blood level; Adolescent; Adult; Aged; Aged, 80 and over; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Female; HIV Infections; HIV-1; Humans; Male; Middle Aged; Osteonecrosis; Taiwan
Type
journal article