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Numerous studies support an association between HIV infection and low bone-mineral density (BMD), but teasing out specific risk factors has been difficult, and establishing a connection to the clinical endpoint of fracture has been even more challenging. Researchers probed a giant Veterans Affairs database for clues, focusing on approximately 40,000 HIV-infected male veterans and 80,000 age-, sex-, and race-matched controls.
During almost 7 years of observation, the HIV-infected men had a significantly higher incidence of hip, vertebral, and upper arm fractures than did the uninfected men (2.5 vs. 1.9 per 1000 person-years). However, when researchers accounted for common predictors of fracture, such as alcohol abuse, smoking, liver disease, …