Important note: Information in this article was accurate in September 2002. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; September 9, 2002
Michael Greer, Senior Medical Writer
"Osteonecrosis has been reported to occur occasionally among HIV-infected patients," according to Kirk D. Miller and colleagues at the National Institutes of Health in Bethesda, Maryland.
Although this condition has not been a major concern in the past, hip osteonecrosis was seen in a surprisingly high proportion of patients treated for HIV, Miller and coauthors found.
The researchers compared osteonecrosis rates in two groups of 339 asymptomatic HIV patients and 118 age- and gender-matched seronegative controls. Magnetic resonance imaging of hip bones was used to find and diagnose osteonecrosis in patients and controls, they noted.
Over 4% (15 of 339, 4.4%) of the HIV+ study participants had necrotic hip bone lesions detectable by MRI, according to the report. By contrast, osteonecrotic lesions were not seen in MRI scans of any of the healthy controls.
Osteonecrosis risk factors for HIV patients included high testosterone levels (through exercise or hormone supplements), anticardiolipin antibodies, and the use of lipid-reducing drugs or systemic corticosteroids (High prevalence of osteonecrosis of the femoral head in HIV-infected adults. Annals of Internal Medicine 2002 Jul 2;137(1):17-25).
"Patients infected with HIV have an unexpectedly high occurrence of osteonecrosis of the hip," Miller and colleagues concluded. "Although screening asymptomatic patients is not warranted, HIV-infected patients with persistent groin or hip pain should be evaluated for this debilitating complication."
The corresponding author for this report is Joseph A. Kovacs, National Institutes of Health, Building 10, Room 7D43, MSC1662, Bethesda, MD 20892 USA. E-mail: jkovacs@niaid.nih.gov.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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