Associations Between Antiretroviral Treatment and Avascular Bone Necrosis: The Swiss HIV Cohort Study.

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State: Public
Version: Final published version
Serval ID
serval:BIB_7D2766B299F9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Associations Between Antiretroviral Treatment and Avascular Bone Necrosis: The Swiss HIV Cohort Study.
Journal
Open forum infectious diseases
Author(s)
Bayard C., Ledergerber B., Flepp M., Lecompte T., Moulin E., Hoffmann M., Weber R., Staehelin C., Di Benedetto C., Fux C.A., Tarr P.E., Hasse B.
Working group(s)
Swiss HIV Cohort Study
Contributor(s)
Aubert V., Battegay M., Bernasconi E., Böni J., Braun D.L., Bucher H.C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fehr J., Fellay J., Furrer H., Fux C.A., Günthard H.F., Haerry D., Hasse B., Hirsch H.H., Hoffmann M., Hösli I., Kahlert C., Kaiser L., Keiser O., Klimkait T., Kouyos R.D., Kovari H., Ledergerber B., Martinetti G., Martinez de Tejada B., Marzolini C., Metzner K.J., Müller N., Nicca D., Pantaleo G., Paioni P., Rauch A., Rudin C., Scherrer A.U., Schmid P., Speck R., Stöckle M., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S.
ISSN
2328-8957 (Print)
ISSN-L
2328-8957
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
4
Number
4
Pages
ofx177
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
HIV-infected individuals have an increased risk of avascular bone necrosis (AVN). Antiretroviral therapy (ART) and particularly protease inhibitors (PI) have been implicated as a risk factor. We aimed to study the associations of ART with the occurrence of AVN among Swiss HIV Cohort Study participants (SHCS).
We used incidence density sampling to perform a case control study within the Swiss HIV Cohort Study (SHCS) comparing prospectively collected AVN cases and controls by conditional logistic regression analysis. To evaluate the effect of ART, multivariable models were adjusted for HIV transmission risk group, age, alcohol consumption, use of corticosteroids, CD4 nadir, maximum viral load, and pancreatitis.
We compared 74 AVN cases and 145 controls. Associations with AVN were shown for heterosexual HIV acquisition (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.1-10), alcohol consumption (OR, 2.7; 95% CI, 1.3-5.7), and hyperlipidemia (OR, 3.6; 95% CI, 1.4-9.6). After adding ART substances to the multivariable base model, there was evidence of an association for treatment with tenofovir (TDF) >1 year (OR, 4.4; 95% CI, 1.4-14) with AVN. Neither exposure to specific frequently prescribed ART combinations or ART drug classes nor cumulative ART exposure showed any associations with AVN.
In the HIV-infected population, a combination of risk factors such as heterosexual HIV acquisition, moderate to severe alcohol intake, and hyperlipidemia seem to contribute to AVN. ART does not seem to be a relevant risk factor for AVN. The association of prolonged TDF exposure with AVN needs to be confirmed.

Keywords
HIV, antiretroviral therapy, avascular bone necrosis, tenofovir
Pubmed
Web of science
Open Access
Yes
Create date
26/10/2017 15:58
Last modification date
20/08/2019 14:38
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