High Prevalence of Osteonecrosis of the Femoral Head in HIV-Infected Adults

Miller, Kirk D.; Masur, Henry; Jones, Elizabeth; Joe, Galen O.; Rick, Margaret E.; Kelly, Gerald D.; Mican, JoAnn M.; Liu, Shuying; Gerber, Lynn H.; Blackwelder, William C.; Falloon, Judith; Davey, Richard T.; Polis, Michael A.; Walker, Robert; Lane, H. Clifford; Kovács, J.

doi:10.7326/0003-4819-137-1-200207020-00008

Cited by 172 publications

(129 citation statements)

References 38 publications

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“…Hip has been identified as the most frequent location of osteonecrosis, and the prevalence was estimated as around 4% by MRI. 18 One subject with RA who had been excluded from the study experienced remission of arthritic symptoms and immunosuppression because of HIV infection. After receiving 3 years of HAART regimen, she had relapse of RA with joint pain and repeated Baker's cyst formation.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of rheumatic manifestations in HIV patients: A cross-sectional study from Manipur, India

Naorem

Arvind

Bimol

et al. 2017

IJRCI

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Section: Discussionmentioning

confidence: 99%

Prevalence of rheumatic manifestations in HIV patients: A cross-sectional study from Manipur, India

Naorem

Arvind

Bimol

et al. 2017

IJRCI

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“…Although numerous treatment algorithms have been proposed to provide guidance to the treating physician [18,19,45,58,64], controversy remains surrounding the most appropriate surgery and at what stage of the disease process these procedures should be performed [9,10,34,50,59,60].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Femoral Head Osteonecrosis in the United States: 16-year Analysis of the Nationwide Inpatient Sample

Johnson

Mont

Tsao

et al. 2013

Clin Orthop Relat Res

107

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“…Several studies have attempted to identify risk factors related to these bone disorders [15]. Hyperlipidaemia, lipodystrophy, diabetes and vasculitis have been described as conditions associated with, or related to, bone disorders [16][17][18] and some risk factors have been suggested, such as alcohol abuse, smoking, hyperlactataemia and corticosteroid use [16,[19][20][21][22][23]. It has also been suggested that bone loss could be the consequence of HIV infection itself [7,11,24,25].…”

Section: Introductionmentioning

confidence: 99%

Symptomatic bone disorders in HIV‐infected patients: incidence in the Aquitaine cohort (1999–2002)

et al. 2004

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Background Since the inception of highly active antiretroviral therapy (HAART), mortality among HIV‐infected patients has decreased, but this has been accompanied by the appearance of several complications. Objectives To estimate the incidence of symptomatic bone disorders in HIV‐infected patients of the Aquitaine cohort (from south‐west France) for the period 1999–2002, and to describe cases. Methods We retrospectively studied the records of 2700 patients of the Aquitaine cohort, which was derived from a hospital‐based surveillance system of HIV infection in France. All cases of symptomatic bone disorders diagnosed from 1 January 1999 to 30 June 2002 were reviewed. Results Fourteen cases of bone disorders were diagnosed, eight cases of aseptic osteonecrosis and six cases of severe osteoporosis, representing incidences of 0.3/1000 patient‐years [95% confidence interval (CI): 0.14–0.62] and 0.22/1000 patient‐years (95% CI: 0.09–0.52), respectively. All patients with aseptic osteonecrosis were male, while all but one with osteoporosis were female. The ages of patients ranged from 36 to 54 years for osteonecrosis and from 39 to 50 for severe osteoporosis. At the time of clinical diagnosis, all patients were treated with nucleoside reverse transcriptase inhibitors (duration of treatment ranging from 19 to 123 months for osteonecrosis and from 46 to 132 months for severe osteoporosis). Ten patients were treated with nonnucleoside reverse transcriptase inhibitors [duration of treatment ranging from 6 to 31 months for osteonecrosis (n=6) and from 4 to 29 months for severe osteoporosis (n=4)]. Thirteen patients were treated with protease inhibitors [duration of treatment ranging from 12 to 62 months for osteonecrosis (n=8) and from 3 to 44 months for severe osteoporosis (n=5)]. All osteonecrosis and five osteoporosis patients had at least one known risk factor or comorbidity associated with the bone disorder occurrence. Conclusions In our study, the aetiology of clinical bone disorders seemed to be multifactorial, as almost all the patients had at least one possible risk factor in addition to HAART exposure.

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High Prevalence of Osteonecrosis of the Femoral Head in HIV-Infected Adults

Abstract: Patients infected with HIV have an unexpectedly high occurrence of osteonecrosis of the hip. Although screening asymptomatic patients is not warranted, HIV-infected patients with persistent groin or hip pain should be evaluated for this debilitating complication.

Cited by 172 publications

References 38 publications

Prevalence of rheumatic manifestations in HIV patients: A cross-sectional study from Manipur, India

Prevalence of rheumatic manifestations in HIV patients: A cross-sectional study from Manipur, India

Treatment of Femoral Head Osteonecrosis in the United States: 16-year Analysis of the Nationwide Inpatient Sample

Symptomatic bone disorders in HIV‐infected patients: incidence in the Aquitaine cohort (1999–2002)

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