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Osteonecrosis in Patients Infected with Human Immunodeficiency Virus: A Case-Control Study

Marshall J. Glesby, Donald R. Hoover and Carlos M. Vaamonde
The Journal of Infectious Diseases
Vol. 184, No. 4 (Aug. 15, 2001), pp. 519-523
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/30137198
Page Count: 5
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Osteonecrosis in Patients Infected with Human Immunodeficiency Virus: A Case-Control Study
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Abstract

To evaluate risk factors for osteonecrosis in human immunodeficiency virus (HIV)-infected patients, demographic and clinical characteristics of case patients (n = 17) and control patients (n = 34) matched on initial clinic visit date, length of follow-up, and baseline CD4 cell count were compared. Case patients were more likely to have received corticosteroids (47.1% vs. 8.8%; matched odds ratio [OR], 13.1; 95% confidence interval [CI], 1.6-106), to have had an increase in CD4 cell count from nadir < 0.050 X 109 cells/L (64.7% vs. 35.7%; OR, 4.9; 95% CI, 1.0-24), and to have had Pneumocystis carinii pneumonia (52.9% vs. 11.8%; OR, 7.6; 95% CI, 1.6-36). Use of protease inhibitors and history of other opportunistic infections did not significantly differ. In multivariate analysis, use of corticosteroids remained significantly associated with osteonecrosis, independently of HIV disease stage and protease inhibitor therapy. Corticosteroid use is an important risk factor for osteonecrosis, but its pathogenesis is likely multifactorial.

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