The Hidden Burden of Fractures in People Living With HIV

Premaor, Melissa Orlandin; Compston, Juliet

doi:10.1002/jbm4.10055

Cited by 33 publications

(26 citation statements)

References 115 publications

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“…6 ). Another patient was living with human immunodeficiency virus (HIV) which has been associated with a higher fracture risk [ 50 , 51 ], and one patient was treated for osteoporosis. Osteoporosis has been considered a risk factor for acromion and scapular spine fractures after RSA in previous studies [ 21 , 24 , 27 , 29 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review

Nyffeler

Altioklar

Bissig

2020

International Orthopaedics (SICOT)

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Purpose Fractures of the acromion and the scapular spine are serious complications after reverse total shoulder arthroplasty. They concern about 4 to 5% of the patients and always result in a significant deterioration of shoulder function. Different causes have been taken into consideration, particularly stress or fatigue fractures. The purpose of the present study was to analyse our own cases and to discuss the causes reported in the literature. Methods We reviewed our shoulder arthroplasty registry and the consultation reports of the last ten years. The charts and radiographs of all patients who had a post-operative fracture of the acromion or the scapular spine were carefully examined and the results were compared with those of an age- and gender-matched control group. Results Twelve patients with an average age of 79 years sustained a fracture of the acromion (n = 6) or the scapular spine (n = 6). The time interval between the operation and the fracture averaged 26 months and ranged from three weeks to 70 months. Eight patients (67%) had a trauma. Seven of them reported a fall on the corresponding shoulder and one a heavy blow on the acromion. The four non-traumatic fractures were attributed to poor bone quality. All 12 patients had immediate pain and difficulty to actively elevate the affected arm. The time interval between the fracture and its diagnosis averaged ten weeks (0 to 10 months). At final follow-up, all patients could reach their face and refused further surgery. Two patients rated their result as good, six as acceptable and four as poor. Conclusions Our study cannot support the hypothesis that most acromion and scapular spine fractures after RSA are the result of increased tension in the deltoid or stress fractures. In our series, the majority of the fractures were related to a fall. Implantation of a reverse prosthesis exposes the acromion and makes it more vulnerable to direct trauma. Non-traumatic fractures were associated with poor bone quality.

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Section: Discussionmentioning

confidence: 99%

Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review

Nyffeler

Altioklar

Bissig

2020

International Orthopaedics (SICOT)

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“…HIV infection or several components of antiretroviral cocktail therapy could cause to bone loss. 20,21 Therefore, it is difficult to confirm the correlation between TDF and mandibular osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Probiotics protect against tenofovir‐induced mandibular bone loss in mice by rescuing mandible‐derived mesenchymal stem cell proliferation and osteogenic differentiation

Líu

et al. 2019

J of Oral Rehabilitation

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Background: Tenofovir disoproxil fumarate (TDF), a primary antiretroviral agent used to treat AIDS, triggers systematic bone loss. However, the effect of TDF on osteopenia or osteoporosis in the jaw remains unclear. TDF-induced bone loss in the jaw, if any, likely involves mandible-derived mesenchymal stem cells (MMSCs), which play a key role in jawbone metabolism. Probiotics prevent long bone loss, and could prove efficacious in treating TDF-induced mandibular bone loss. Objectives: To determine whether TDF triggers mandibular bone loss, elucidate the underlying mechanisms, and study the effect of Lactobacillus rhamnosus GG (LGG) on TDF-induced bone loss in the jaw. Methods: Tenofovir disoproxil fumarate was administered orally daily and LGG semiweekly from eight weeks to the end of the study (LGG group) to male C57BL6/J mice. The mice were sacrificed, and body weight (BW) and serum Ca and P were measured. Mandibular histomorphometry was evaluated by micro-CT. MMSCs and LGG culture supernatants were isolated, and MMSC proliferation and ALP production when treated with different concentrations of LGG supernatant and/or TDF were measured. Relative abundance of osteogenic markers was assessed by qPCR. Results: Orally administered LGG protected against bone mass loss and deterioration of bone microarchitecture and increased serum P levels. The BW of the TDF group was highest among the study groups. TDF partially impaired osteogenesis and proliferation of MMSCs. LGG culture supernatant rescued MMSC osteogenesis and proliferation, and osteogenic gene expression. Conclusions: Lactobacillus rhamnosus GG protected against tenofovir-induced mandibular bone loss in mice by rescuing MMSC proliferation and osteogenesis. How to cite this article: Liu H, Gu R, Li W, et al. Probiotics protect against tenofovir-induced mandibular bone loss in mice by rescuing mandible-derived mesenchymal stem cell proliferation and osteogenic differentiation.

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“…Similarly, another meta-analysis including 10 studies showed that HIV-positive patients had a 2.17-fold greater risk for all fractures than HIV-negative individuals [1]. It is important to note that 19 out of the 20 studies included in these two meta-analyses were carried out in men aged 36 to 55 years [1,7].…”

Section: Introductionmentioning

confidence: 98%

“…in a meta‐analysis found a crude incidence ratio of 1.58 (95% confidence interval (CI) 1.25 to 2.00) for any fracture in HIV‐positive patients compared with HIV‐negative individuals . Similarly, another meta‐analysis including 10 studies showed that HIV‐positive patients had a 2.17‐fold greater risk for all fractures than HIV‐negative individuals . It is important to note that 19 out of the 20 studies included in these two meta‐analyses were carried out in men aged 36 to 55 years .…”

Section: Introductionmentioning

confidence: 98%

Performance of fracture risk assessment tool in HIV‐positive male individuals aged ≥45 years on suppressive antiretroviral therapy

et al. 2019

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Introduction An age‐specific evaluation and management algorithm for reduced bone mineral density ( BMD ) is suggested for HIV‐positive patients without major risk factors. Whether combination of BMD and the Fracture Risk Assessment Tool ( FRAX ) may detect more individuals for therapeutic interventions remains unclear. We aimed to determine the prevalence of middle‐aged or older HIV‐positive males fitting the criteria of therapeutic interventions with different approaches. Methods From July 2016 to February 2018, HIV‐positive male patients aged ≥45 years receiving suppressive antiretroviral therapy were recruited in a cross‐sectional study, at two designated hospitals for HIV care in northern Taiwan. Patients with malignancy, AIDS , pre‐existing bone disease or immobilization were excluded. Information on clinical and demographic characteristics, FRAX questionnaire, activity questionnaire, BMD and serum 25( OH )D was obtained. FRAX scores combined with BMD ( FRAX / BMD ) and without BMD ( FRAX ) were calculated. The data were analysed on the basis of major risk factors for fragility fracture and age stratification, FRAX score and BMD results respectively. Results We enrolled 330 patients with a mean age of 51.6 years and CD 4 610 cells/μL, in whom 98.1% (n = 324) underwent BMD assessment of one site or more. By FRAX , 6.7% (n = 22) reached treatment thresholds (10‐year risk of major osteoporotic fracture ≥20% and/or hip fracture ≥3%). The prevalence of osteopenia (−2.5

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The Hidden Burden of Fractures in People Living With HIV

Cited by 33 publications

References 115 publications

Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review

Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review

Probiotics protect against tenofovir‐induced mandibular bone loss in mice by rescuing mandible‐derived mesenchymal stem cell proliferation and osteogenic differentiation

Performance of fracture risk assessment tool in HIV‐positive male individuals aged ≥45 years on suppressive antiretroviral therapy

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