Ho Y.-C.TIFFANY TING-FANG SHIHLin Y.-H.Hsiao C.-F.Chen M.-Y.SZU-MIN HSIEHWANG-HUEI SHENGHSIN-YUN SUNCHIEN-CHING HUNGSHAN-CHWEN CHANG2021-12-012021-12-0120071344-6304https://www.scopus.com/inward/record.uri?eid=2-s2.0-36549038618&partnerID=40&md5=9cb8c8f198fe809ea06440050ba2bd39https://scholars.lib.ntu.edu.tw/handle/123456789/588924Osteonecrosis, 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]SDG3alendronic 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; Taiwanjournal article180328392-s2.0-36549038618