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Poor Bone Prevention/Care in VA
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"Prior to issuance of the 2010 guidance, only a very small proportion of HIV-infected US Veterans ≥ 50 years old received primary or secondary fracture prevention.
·If still the case, an effort to educate HIV providers on prevention and management of OF would be needed.
We carried out a retrospective analysis of HIV-infected patients in care at the US Veterans Affairs network
·Follow-up included those ≥ 50 years old from 1996 to 2010, who experienced an incident osteoporotic fractures (OF: defined as wrist, hip or vertebral fracture); identified by new ICD-9 codes.
An incident OF occurred in 811 patients during a total follow-up time of 277,392 patient-years; rate: 2.92/1000 patient-years.
·Prior to incident fracture, 1735 (7.3%) had a DXA scan done, and 3242 (13.6%) had vitamin D levels measured.
Secondary OF preventive assessments:
·Among patients with incident OF, 198 (24.4%) had a recurrent fracture during a 2828 person-years of post-fracture follow-up; recurrence rate: 70.01/1000 patient-years.
Secondary OF interventions:
·Following the incident OF, a DXA scan was performed only in 139 (17.1%) of patients, and 238 (29.4%) had a Vitamin D measurement. Calcium or vit D supplementation were prescribed in 295 (36.4%), and bisphosphonates in 89 (11%) patients."
Evaluation and Management of Fracture Risk in HIV Patients in the VA system
Reported by Jules Levin
IAS 2015 Vancouver July 19-23
James Cutrell1,2, Song Zhang2, Henning Drechsler1,2, Pablo Tebas3, Naim Maalouf1,2, Roger Bedimo1,2 1VA North Texas Health Care System, Dallas, TX, 2University of Texas Southwestern, Dallas, TX, 3University of Pennsylvania, Philadelphia, PA
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