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Prospective clinical trials have shown a significantly greater decline in bone-mineral density with tenofovir-based treatments than with other regimens, but they have failed to demonstrate a difference in clinical endpoints. Now, a large observational cohort study — reported at the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention [Bedimo R et al. Abstract MOAB0101] — suggests that tenofovir use increases the risk for fracture.
Researchers evaluated data from 56,600 HIV-infected individuals in the Veterans Affairs' Clinical Case Registry to explore possible associations between drug exposure and osteoporotic fracture, defined as any vertebral, hip, or wrist fracture (ascertained by ICD-9 diagnosis codes). When the analysis was…