{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:17:42Z","timestamp":1777555062959,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Current guidelines recommend screening people with HIV (PWH) for bone disease using predictive tools developed for the general population, although data on PWH are scarce. In this study, we assessed the performance of FRAX and QFracture scoring systems to predict the occurrence of fragility fractures in a prospective cohort of 17,671 adults with human immunodeficiency virus (HIV) included in the HIV\/AIDS research network (CoRIS) in Spain. The survival estimates of fragility fractures during follow-up were calculated and FRAX and QFracture scores were computed at cohort inclusion. For both tools, discriminatory measures and the observed-to-expected (O\/E) ratios were assessed. During a follow-up time of 42,411.55 person-years, 113 fragility fractures were recorded. Areas under the curve were 0.66 [95% confidence interval (95% CI) 0.61\u20130.71] for FRAX and 0.67 (95% CI 0.62\u20130.73) for QFracture for major osteoporotic fractures, and 0.72 (95% CI 0.57\u20130.88) and 0.81 (95% CI 0.68\u20130.95) for hip fracture, respectively. The O\/E was 1.67 for FRAX and 5.49 for QFracture for major osteoporotic fractures, and 11.23 for FRAX and 4.87 for QFracture for hip fractures. Moreover, O\/E raised as the risk increased for both tools and in almost all age groups. When using the recommended assessment thresholds, &lt;6% and 10% of major osteoporotic and hip fractures would have been identified, respectively. In conclusion, FRAX and QFracture displayed acceptable discrimination, although both tools significantly underestimated the risk of fragility fractures in PWH. The recommended assessment thresholds may not be appropriate for this population as they were unable to identify individuals with fragility fractures during follow-up.<\/jats:p>","DOI":"10.1089\/apc.2022.0183","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T13:27:33Z","timestamp":1672234053000},"page":"11-21","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Improving Recognition of Fracture Risk in People with Human Immunodeficiency Virus: Performance and Model Contribution of Two Common Risk Assessment Tools"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8553-6995","authenticated-orcid":false,"given":"Pilar","family":"Vizcarra","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Ram\u00f3n y Cajal University Hospital, IRyCIS, Madrid, Spain."},{"name":"Universidad de Alcal\u00e1, Ram\u00f3n y Cajal University Hospital, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Ram\u00f3n y Cajal University Hospital, IRyCIS, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda J.","family":"Vivancos","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Ram\u00f3n y Cajal University Hospital, IRyCIS, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso Muriel","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Ram\u00f3n y Cajal University Hospital, Centro de Investigaci\u00f3n Biom\u00e9dica en Red, Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Universidad de Alcal\u00e1, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo Pelazas","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario de Canarias, Canarias, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9485-6867","authenticated-orcid":false,"given":"F\u00e9lix","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Hospital General Universitario de Elche &amp; University Miguel Hern\u00e1ndez, Alicante, CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana Corona","family":"Mata","sequence":"additional","affiliation":[{"name":"Clinical Virology and Zoonoses Group, Unit of Infectious Diseases, Instituto Maim\u00f3nides de Investigaci\u00f3n Biom\u00e9dica de C\u00f3rdoba (IMIBIC), Hospital Universitario Reina Sof\u00eda, Universidad de C\u00f3rdoba, C\u00f3rdoba, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pepa","family":"Galindo","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Cl\u00ednico Universitario de Valencia, Valencia, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Calzado","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Parc Tauli Hospital Universitari, Sabadell, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 L.","family":"Casado","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Ram\u00f3n y Cajal University Hospital, IRyCIS, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"CoRIS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,1,9]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2020.0051"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002082"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(15)00077-6"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2018.1476661"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir627"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-013-2506-3"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328361d241"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328340a28d"},{"issue":"2","key":"e_1_3_6_10_2","first-page":"59","article-title":"Renal and bone toxicity with the use of tenofovir: Understanding at the end","volume":"18","author":"Casado JL","year":"2016","unstructured":"Casado JL. Renal and bone toxicity with the use of tenofovir: Understanding at the end. AIDS Rev, 2016; 18(2):59\u201368.","journal-title":"AIDS Rev"},{"key":"e_1_3_6_11_2","article-title":"European Guidelines for the Treatment of People Living with HIV (PLWH)","author":"European AIDS Clinical Society","year":"2021","unstructured":"European AIDS Clinical Society. European Guidelines for the Treatment of People Living with HIV (PLWH). Version 11.0 October, 2021; 2021. Available from: https:\/\/www.eacsociety.org\/media\/final2021eacsguidelinesv11.0_oct2021.pdf [Last accessed: February 25, 2022].","journal-title":"Version 11.0 October"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eimc.2017.03.010"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001864"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000998"},{"key":"e_1_3_6_15_2","unstructured":"Kanis JA. FRAX\u00ae Fracture Risk Assessment Tool. 2011. 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Available at: https:\/\/nottingham-repository.worktribe.com\/output\/1009571."},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0107695"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-018-0464-2"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.3851\/IMP2979"},{"key":"e_1_3_6_31_2","volume-title":"Conference on Retroviruses Opportunistic Infect","author":"Battalora LA","year":"2019","unstructured":"Battalora LA, , Armon C, , Palella FJ, et al. Breaking Bones Is Bad: Incident Fracture and Mortality in the HIV Outpatient Study. In: Conference on Retroviruses Opportunistic Infect. 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