Abstract | BACKGROUND:
Osteonecrosis (avascular necrosis) has been infrequently reported in HIV-infected patients. It is not known whether HIV itself is an independent risk factor for osteonecrosis. METHODS: We identified 25 patients with osteonecrosis from 1984 to 1999 from a large county teaching hospital and two large practices in Dallas County that specialize in HIV-disease related therapy. A retrospective chart review was performed to evaluate potential risk factors for osteonecrosis. Each case was matched with two controls for HIV positive status and date of osteonecrosis diagnosis. RESULTS: In the study, 22 of 25 (88%) case patients had at least one osteonecrosis risk factor compared with 24 of 50 (48%) controls, p =.003. The most common osteonecrosis risk factors were hyperlipidemia (32%), alcoholism (28%), pancreatitis (16%), corticosteroids (12%), and hypercoaguability (12%). Of the cases, 12% were idiopathic. Multiple joints were involved in 72% of cases. Four of the case patients compared with none of the controls received megesterol acetate before the diagnosis of osteonecrosis, p =.01. No significant differences were found between cases and controls with respect to liver function tests, testosterone levels, triglyceride levels, cholesterol levels, or CD4 cell counts. Saquinavir was independently associated with osteonecrosis, p <.05. However, no differences in overall use of protease inhibitors among cases and controls were noted: 79% versus 76%, respectively. CONCLUSIONS:
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Authors | A N Scribner, P V Troia-Cancio, B A Cox, D Marcantonio, F Hamid, P Keiser, M Levi, B Allen, K Murphy, R E Jones, D J Skiest |
Journal | Journal of acquired immune deficiency syndromes (1999)
(J Acquir Immune Defic Syndr)
Vol. 25
Issue 1
Pg. 19-25
(Sep 01 2000)
ISSN: 1525-4135 [Print] United States |
PMID | 11064500
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- HIV Protease Inhibitors
- Triglycerides
- Testosterone
- Cholesterol
- Saquinavir
- Megestrol Acetate
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Topics |
- Adult
- CD4 Lymphocyte Count
- Case-Control Studies
- Cholesterol
(analysis)
- Female
- HIV Infections
(complications, drug therapy)
- HIV Protease Inhibitors
(therapeutic use)
- Humans
- Incidence
- Male
- Megestrol Acetate
(pharmacology)
- Osteonecrosis
(chemically induced, complications, epidemiology, immunology)
- Retrospective Studies
- Risk Factors
- Saquinavir
(therapeutic use)
- Testosterone
(analysis)
- Triglycerides
(analysis)
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