2184. Veterans Aging Cohort Study Index as a Marker of Bone Disease in HIV-Infected Patients
Session: Poster Abstract Session: HIV Renal and Bones
Saturday, October 29, 2016
Room: Poster Hall
Background:Human immunodeficiency virus (HIV)-infected individuals have a higher risk of low bone mineral density (BMD) and fragility fracture. Current guidelines recommend dual-energy X-ray absorptiometry (DXA) scan for HIV infected patients greater than 50 years of age. Fracture Risk Assessment Tool (FRAX) score is often used as a marker to identify HIV-infected patients who should be assessed with DXA scanning for low BMD. The aim of our retrospective study was to explore if HIV specific Veterans Aging Cohort Study (VACS) Index and its specific components could similarly help identify patients at risk for osteopenia.

Methods: 195 HIV-infected patients with DXA scan were included. T-scores (12 postmenopausal women and 156 male patients ≥50 years of age) and Z scores (27 male patients <50 years of age) less than – 1 were used to classify patients with osteopenia. VACS index was calculated using laboratory values closest to the date of DXA scan. Logistic regression was used to assess the association between VACS index score and also individual components of VACS index and presence of osteopenia after adjusting for confounding variables.

Results: 109 (56%) patients were diagnosed with osteopenia on DXA scans. Median VACS score did not differ significantly between the two groups (31 versus 26, p=0.14). White race (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.5–5.23) and weight (OR, 0.95; 95% CI, .93–.97) were significantly associated with osteopenia. After adjusting for these variables, VACS index score was significantly associated with osteopenia, with the odds of osteopenia increasing 1.22 times for each 10 unit increase in VACS index score (95% CI, 1.01, 1.51; p=0.04). Similarly, component of the VACS Index most strongly associated with osteopenia was Hepatitis C coinfection (HR, 3.19; 95% CI, 1.14–8.93).

Conclusion: VACS index score, previously demonstrated to be a marker of frailty in HIV infected patients; is significantly associated with risk of osteopenia and could be used to develop a prediction score. In the meantime, Hepatitis C coinfection, white race and low body weight can we used as markers to identify HIV infected patients at higher risk of developing osteopenia and guide clinicians to order DXA scans in resource limited setting.

Lokesh Shahani, MD, MPH, University of Texas - McGovern Medical School, houston, TX, Katharine Breaux, PA-C, MPAS, Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX and Maria Rodriguez-Barradas, MD, FIDSA, Section of Infectious Disease, Department of Medicine, Michael E. DeBakey VAMC, Houston, TX

Disclosures:

L. Shahani, None

K. Breaux, None

M. Rodriguez-Barradas, None

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