{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:53:46Z","timestamp":1777452826266,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"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":["Antiviral Therapy"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prevalence rates of low bone mineral density (BMD) and bone fractures are higher among HIV-infected adults compared with the general United States (US) population, but the relationship between BMD and incident fractures in HIV-infected persons has not been well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Dual energy X-ray absorptiometry (DXA) results of the femoral neck of the hip and clinical data were obtained prospectively during 2004-2012 from participants in two HIV cohort studies. Low BMD was defined by a T-score in the interval &gt;-2.5 to &lt;-1.0 (osteopenia) or \u2264-2.5 (osteoporosis). We analysed the association of low BMD with risk of subsequent incident fractures, adjusted for sociodemographics, other risk factors and covariables, using multivariable proportional hazards regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1,006 participants analysed (median age 43 years [IQR 36\u201349], 83% male, 67% non-Hispanic white, median CD4\n                      <jats:sup>+<\/jats:sup>\n                      T-cell count 461 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      [IQR 311\u2013658]), 36% ( n=358) had osteopenia and 4% ( n=37) osteoporosis; 67 had a prior fracture documented. During 4,068 person-years of observation after DXA scanning, 85 incident fractures occurred, predominantly rib\/sternum ( n=18), hand ( n=14), foot ( n=13) and wrist ( n=11). In multivariable analyses, osteoporosis (adjusted hazard ratio [aHR] 4.02, 95% CI 2.02, 8.01) and current\/prior tobacco use (aHR 1.59, 95% CI 1.02, 2.50) were associated with incident fracture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large sample of HIV-infected adults in the US, low baseline BMD was significantly associated with elevated risk of incident fracture. There is potential value of DXA screening in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3851\/imp2979","type":"journal-article","created":{"date-parts":[[2015,7,21]],"date-time":"2015-07-21T06:51:59Z","timestamp":1437461519000},"page":"45-54","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Low Bone Mineral Density and Risk of Incident Fracture in HIV-Infected Adults"],"prefix":"10.1177","volume":"21","author":[{"given":"Linda","family":"Battalora","sequence":"first","affiliation":[{"name":"Colorado School of Mines, Golden, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Buchacz","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Armon","sequence":"additional","affiliation":[{"name":"Cerner Corporation, Kansas City, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar T","family":"Overton","sequence":"additional","affiliation":[{"name":"University of Alabama School of Medicine, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Hammer","sequence":"additional","affiliation":[{"name":"Denver Infectious Disease Consultants, Denver, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pragna","family":"Patel","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan S","family":"Chmiel","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy","family":"Wood","sequence":"additional","affiliation":[{"name":"Cerner Corporation, Kansas City, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy J","family":"Bush","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John R","family":"Spear","sequence":"additional","affiliation":[{"name":"Colorado School of Mines, Golden, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John T","family":"Brooks","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Young","sequence":"additional","affiliation":[{"name":"APEX Family Medicine, Denver, CO, USA"},{"name":"International Association of Providers of AIDS Care, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the HIV Outpatient Study (HOPS) and SUN Study Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,1,1]]},"reference":[{"key":"bibr1-IMP2979","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32801022eb"},{"key":"bibr2-IMP2979","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2015.0158"},{"key":"bibr3-IMP2979","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200003100-00005"},{"key":"bibr4-IMP2979","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32835192ae"},{"key":"bibr5-IMP2979","doi-asserted-by":"publisher","DOI":"10.1007\/s001980050093"},{"key":"bibr6-IMP2979","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir188"},{"key":"bibr7-IMP2979","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32833f6294"},{"key":"bibr8-IMP2979","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.21266"},{"key":"bibr9-IMP2979","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000320"},{"key":"bibr10-IMP2979","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32834ed8a7"},{"key":"bibr11-IMP2979","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0828"},{"key":"bibr12-IMP2979","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq242"},{"key":"bibr13-IMP2979","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(99)00005-8"},{"key":"bibr14-IMP2979","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn361"},{"key":"bibr15-IMP2979","unstructured":"World Health Organization. Assessment of osteoporosis at the primary health care level. Geneva: Summary Report of a WHO Scientific Group; 2007. (Accessed 3 October 2015. Updated 2 October 2015.) Available from www.who.int\/chp\/topics\/rheumatic\/en\/index.html."},{"key":"bibr16-IMP2979","first-page":"1","volume":"843","author":"Assessment of fracture risk and its application to screening for post-menopausal osteoporosis.","year":"1994","journal-title":"World Health Organization Technical Report Series"},{"key":"bibr17-IMP2979","unstructured":"International Society for Clinical Densitometry. Official Positions-Adult 2013 (July 2013). (Accessed 3 October 2015. Updated 18 June 2015.) Available from: http:\/\/www.iscd.org\/official-positions\/2013-iscd-official-positions-adult\/."},{"key":"bibr18-IMP2979","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis687"},{"key":"bibr19-IMP2979","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0023688"},{"key":"bibr20-IMP2979","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7041.1254"},{"key":"bibr21-IMP2979","unstructured":"National Osteoporosis Foundation. National Osteoporosis Foundation clinician's guide to prevention and treatment of osteoporosis 2013. (Accessed 7 April 2014. Updated 15 August 2014.) Available from http:\/\/nof.org\/hcp\/clinicians-guide."},{"key":"bibr22-IMP2979","unstructured":"European AIDS Clinical Society. European AIDS Clinical Society Guidelines 2013. (Accessed 7 April 2014. Updated 2015.) Available from http:\/\/www.eacsociety.org\/Portals\/0\/Guidelines_Online_131014.pdf."},{"key":"bibr23-IMP2979","unstructured":"Infectious Disease Society of America. Infectious Disease Society of America (ISDA) Practice Guidelines 2013. (Accessed 7 April 2014. Updated 2015.) Available from http:\/\/www.idsociety.org\/Templates\/Landing.aspx?id=23622320151."},{"key":"bibr24-IMP2979","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents: Department of Health and Human Services; 2014. (Accessed 29 June 2014. Updated 3 October 2015.) Available from http:\/\/aidsinfo.nih.gov\/ContentFiles\/AdultandAdolescentGL.pdf."},{"key":"bibr25-IMP2979","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit757"},{"key":"bibr26-IMP2979","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ010"},{"key":"bibr27-IMP2979","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2014.03.1563"}],"container-title":["Antiviral Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP2979","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP2979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:52:25Z","timestamp":1777380745000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3851\/IMP2979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,1]]}},"alternative-id":["10.3851\/IMP2979"],"URL":"https:\/\/doi.org\/10.3851\/imp2979","relation":{},"ISSN":["1359-6535","2040-2058"],"issn-type":[{"value":"1359-6535","type":"print"},{"value":"2040-2058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1]]}}}