August 6, 2014
A literature review published in the journal AIDS concluded that people infected with both HIV and hepatitis C (HCV) are at significantly higher risk of bone loss (osteoporosis) and bone fractures than those infected only with HIV. The risk is even greater when compared to those not infected with either virus.
The researchers analyzed 15 studies published through 2013. The studies' combined estimated prevalence of osteoporosis was 22% (95% confidence interval [CI], range 12%-31%). Participants infected with both HIV and HCV had a 63% higher risk of osteoporosis compared to participants infected only with HIV.
The risk of bone fractures was 77% higher for HIV/HCV-coinfected participants than for those participants infected only with HIV, and almost two times higher (195%) than for people with neither infection. The pooled incidence rate ratio of overall fracture risk was 1.77 (95% CI, range 1.44-2.18) for HIV/HCV-coinfected participants compared to participants with HIV only, and 2.95 (95% CI, range 2.17-4.01) when compared to those not infected with either virus.
Other factors that increase the risk of osteoporosis -- which in turn leads to a higher risk of fractures -- are lower body mass index, longer-lasting therapy with a protease inhibitor and methadone use, as well as the better-known risk factors of older age, being post-menopausal, smoking and little physical activity.
The study authors concluded that, "These data suggest that HIV/HCV-coinfected individuals should be targeted for fracture prevention through risk factor modification at all ages and DXA screening at age 50."
Barbara Jungwirth is a freelance writer and translator based in New York.
Follow Barbara on Twitter: @reliabletran.
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