AEGiS-15IAC: Impact of treatment with HAART on osteonecrosis (OST) incidence in HIV infected patients.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Impact of treatment with HAART on osteonecrosis (OST) incidence in HIV infected patients.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThOrB1358)

Mary-Krause M, Roudiere L, Billaud E, Simon A, Poizot-Martin I, Costagliola D
Inserm EMI 0214, Paris, France

BACKGROUND: Osteonecrosis has been increasingly associated with HIV disease throughout the 1990s. But, in the current context of side effects of antiretroviral treatments, it is important to study the incidence of osteonecrosis to evaluate if there is an association with exposure to HAART treatment.

METHODS: The French Hospital Database on HIV (FHDH) was started in 1992 in 62 hospitals in France and enrolled HIV seropositive subjects followed in hospitals. The standardized data collection form includes characteristics of exposure group, values of usual biological markers, clinical manifestations, nature of treatments delivered, and death and cause of death as reported in the medical records. A follow-up form is used at each visit or hospital admission where a clinical manifestation is reported, a new treatment is prescribed, or at least every 6 months. Estimates of the standardized morbidity ratios (SMR) of OST associated with the use of HAART were obtained after stratification of all analyses by age at diagnosis or end of follow-up, an AIDS-defining event before diagnosis separated in two groups: those with possible corticoid therapy (PCP, brain toxoplasmosis, non-Hodgkin lymphoma) and the others, period of OST diagnosis or end of follow-up (1996-1997 vs 1998-2002).

RESULTS: OST was diagnosed in 122 patients among 56 259 patients followed between 1 January 1996 and 31 December 2002, corresponding to 176 880 patients-year (PY). [table: see text]

CONCLUSIONS: Osteonecrosis is more frequent among HIV patients treated with HAART. Our results point to a duration-related effect relationship between HAART and OST, with an OST incidence rate increase per 12 months of HAART exposure.

Keywords: AEGIS, HIV, Antiretroviral Therapy, Highly Active, Acquired Immunodeficiency Syndrome, Incidence, HIV Seropositivity, HIV Infections, Osteonecrosis, Anti-HIV Agents, Drug Therapy, Combination, HIV Protease Inhibitors, France, Humans, therapy, epidemiology, pathogenicity, drug therapy

040711
ThOrB1358