BC-CfE research shows no relationship between antiretrovirals and osteoporosis-related fractures

published on March 5, 2019

(Vancouver, BC | March 5, 2019) Research from the BC Centre for Excellence in HIV/AIDS (BC-CfE) has found that a higher proportion of individuals living with HIV have experienced osteoporosis-related fractures (ORF) compared to HIV-negative individuals (6.08% versus 5.45%). However, after accounting for other factors (including sex, injection drug use and age at initiation of HIV treatment), starting HIV treatment early and staying on treatment were associated with a lower likelihood of ORF among people living with HIV—regardless of the antiretroviral treatment (ART) regimen.

In fact, according to the BC-CfE research presented today at the annual Conference on Retroviruses and Opportunistic Infections (CROI), early initiation of any ART and sustained low viral load may reduce the odds of ORF among people living with HIV.

“As individuals age with HIV they have unique health needs, and may be affected by certain health conditions earlier than HIV-negative individuals. Having access to treatment and the capacity to support a healthy lifestyle help ensure positive outcomes for people living with HIV, regardless of age. It’s important that we continue to offer a broad range of accessible treatment and care options and supports,” said Dr. Silvia Guillemi, Director of the Clinical Education and Training Program at the BC-CfE and lead author on the study.

The BC-CfE study, which included linked administrative health data for 6,846 HIV-positive and 514,619 HIV-negative individuals, did not show an association between fractures incidence and exposure to any of the HIV treatment classes (including the drug tenofovir disoproxil fumarate, or tenofovir). Previous studies have documented potential associations between the effects of antiretroviral therapy, particularly tenofovir, and bone fractures; however, these links were not clearly defined. A study presented to the 2017 IAS Conference also found no evidence of an association between tenofovir and ORFs

In keeping with previous research, HIV-positive individuals were found to experience ORF earlier than HIV-negative individuals. Among people living with HIV, 63% of the first ORF cases occurred before the age of 50 compared with 34% in the HIV-negative group. Being female, older age at ART initiation, injection drug use and previous injuries were associated with a higher likelihood of ORF.

“Expanding access to HIV testing and treatment are critical to improving quality of life and longevity for people living with HIV. Further, we know we can curb new infections through this strategy and should continue to pursue this approach internationally by making up-front investments in treatment for all,” said Dr. Robert Hogg, BC-CfE Senior Research Scientist and a co-author on the study.

The analysis was conducted using data from the BC-CfE’s Comparative Outcomes And Service Utilization Trends (COAST) study. COAST is the first of its kind: a population-based study aiming to examine the health outcomes and health service use of men and women living with HIV, as compared to a random 10% sample of the total population of British Columbia.

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About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility – nationally and internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. The made-in-BC Treatment as Prevention strategy (TasP) pioneered by BC-CfE, and supported by UNAIDS since 2011, inspired the ambitious global target for HIV treatment - known as the 90-90-90 Target - to end AIDS as a pandemic by 2030. The BC-CfE is applying TasP to therapeutic areas beyond HIV/AIDS, including viral hepatitis and substance use, to promote Targeted Disease Elimination as a means to contribute to health care sustainability. The BC-CfE works in close collaboration with key stakeholders, including government, health authorities, health care providers, academics, and the community to decrease the health burden of HIV/AIDS, hepatitis C and substance use across Canada and around the world.

For more information, please contact:
Caroline Dobuzinskis, BC-CfE Communications Coordinator
Phone: 604-366-6540, Email: cdobuzin@cfenet.ubc.ca

BC Centre for Excellence in HIV/AIDS

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BC-CfE research shows no relationship between antiretrovirals and osteoporosis-related fractures

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