2186. Risk Factors Associated with Avascular Necrosis in HIV-Infected Patients in the New Antiretroviral Therapy Era
Session: Poster Abstract Session: HIV Renal and Bones
Saturday, October 29, 2016
Room: Poster Hall
  • AVNposterfinal 10-24-16.pdf (129.0 kB)
  • Background: Avascular necrosis (AVN) has been shown to have a higher prevalence in the HIV population. This is partly due to high prevalence of already established risk factors such as hyperlipidemia, alcohol abuse, steroid use as well as the use of protease inhibitors. There have not been any studies looking at risk factors for avascular necrosis in the more recent antiretroviral therapy era.

    Methods: We conducted a case control study among HIV infected individuals who receive care at the Partnership Comprehensive Care Practice at Drexel University, Philadelphia, PA. Cases were retrospectively identified with AVN defined by surgical pathology or imaging. For each case, one control was randomly selected who showed no evidence of AVN and matched for gender and age. Chi-square, Fisher exact and unpaired t-tests were used to compare AVN and control groups on dichotomous or numeric variables. A logistic regression model was used to evaluate the effect of hypothesized risk factors.

    Results: We included 33 cases in our study from 2003 through 2015, 76% were male, 65% African American with a median age of 46+/-7. Using logistic regression analysis of the possible risk factors we found an odds ratio of 7 for detectable viral load and AVN (p=.003). We did not find an association between steroid use or protease inhibitor and AVN.

    Conclusion: A detectable HIV viral load seems to be an independent risk factor for AVN. In contrast to prior case control studies our study did not find an association between protease inhibitor use and avascular necrosis. It is possible that newer protease inhibitors are not associated with avascular necrosis.

    Marcus Sandling, MD1, Nida Arif, MD2, Sara Taherkani, MD3, Ed Gracely, PhD4, Nader Toossi, MD4, Norman Johanson, MD4, Kimberly Dike, BS4 and Zsofia Szep, MD5, (1)Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, (2)Division of Infectious Disease and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, (3)Howard County General Hospital Infectious Disease Associates, Columbia, MD, (4)Drexel University, College of Medicine, Philadelphia, PA, (5)Division of Infectious Diseases & HIV Medicine, Drexel University, College of Medicine, Philadelphia, PA


    M. Sandling, None

    N. Arif, None

    S. Taherkani, None

    E. Gracely, None

    N. Toossi, None

    N. Johanson, None

    K. Dike, None

    Z. Szep, None

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