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Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV

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dc.contributor.author Cabrera, Diego M.
dc.contributor.author Cornejo, Mijahil P.
dc.contributor.author Slotkin, Rebecca
dc.contributor.author Pinedo, Yvett
dc.contributor.author Yu, Wei
dc.contributor.author Guan, Wenmin
dc.contributor.author Garcia Funegra, Patricia Jannet
dc.contributor.author Hsieh, Evelyn
dc.coverage.spatial Lima, Perú
dc.date.accessioned 2023-09-06T20:45:10Z
dc.date.available 2023-09-06T20:45:10Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14097
dc.description.abstract Summary : Osteoporosis and fracture risk among women with HIV in Latin America is understudied. In a sample of Peruvian women with and without HIV, women with HIV had lower femoral neck and total hip BMD and a higher proportion of vertebral fractures. Important treatment gaps were identified across both groups. Purpose: Studies have shown that patients with HIV are at increased risk for bone loss and fracture due to a combination of host, viral, and antiretroviral therapy (ART)-related factors. We aimed to explore the prevalence of vertebral fracture (VF) and low bone mineral density (BMD) among women aging with HIV in Peru and identify risk factors for osteoporosis and fracture in this population. Methods: We enrolled women living with and without HIV aged ≥40 years between 2019 and 2020. Participants completed a survey and obtained dual X-ray absorptiometry (DXA) test to assess BMD at the lumbar spine (LS), femoral neck (FN), and total hip (TH). A subset of patients also obtained lateral thoracolumbar X-rays. Presence of VF was determined using the Genant semiquantitative method. Regression analyses were used to model associations between key risk factors and BMD. Results: 104 women living with HIV and 212 women living without HIV were enrolled with a mean age of 52.4±8.2 and 56.4±8.8 years (p < 0.001). Among postmenopausal women (257/316, 81.3%), 26.3% of women living with HIV and 25.9% of those without HIV had osteoporosis. Among the 88 women living with HIV and 178 women living without HIV who obtained thoracolumbar X-rays, 12.5% and 6.2%, respectively, had at least one VF. Based on DXA and the FRAX score, 22/104 women living with HIV met criteria for osteoporosis treatment according to national guidelines; however, none were on treatment. Propensity score matching revealed that women living with HIV had 0.032 g/cm2 lower FN BMD (p = 0.012) and 0.034 g/cm2 lower TH BMD (p = 0.041) compared to women without HIV. Conclusion: In this study, women living with HIV on long-standing ART had increased VF prevalence compared to the slightly older group of women without HIV. Age and BMI were independent predictors for BMD at the lumbar spine, hip, and femoral neck among women living with HIV, and there was a treatment gap among women who met criteria for osteoporosis treatment. Larger studies are needed in this region to identify individuals at risk for fracture and to inform prevention guidelines. en_US
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartofseries Archives of Osteoporosis
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Osteoporosis en_US
dc.subject Fracture en_US
dc.subject HIV en_US
dc.subject Women en_US
dc.subject Aging en_US
dc.subject Peru en_US
dc.subject.mesh Osteoporosis
dc.subject.mesh VIH
dc.subject.mesh Mujeres
dc.subject.mesh Envejecimiento
dc.subject.mesh Perú
dc.title Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1007/s11657-023-01250-w
dc.relation.issn 1862-3514

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