Low Trauma Fractures in People with HIV: Longitudinal Time Trends in the Swiss HIV Cohort Study 2009-2022

Isabella C Schoepf^{1

2}, Vera Baltisberger¹, Christian W Thorball^{3

4}, Lene Ryom^{5

6

7}, Gilles Wandeler⁸, David Haerry⁹, Christian R Kahlert¹⁰, Enos Bernasconi¹¹, Alexandra Calmy¹², Olivier Lamy¹³, Jacques Fellay^{3

4}, Huldrych F Günthard^{14

15}, Bruno Ledergerber¹⁴, Philip E Tarr¹; Swiss HIV Cohort Study

Collaborators, Affiliations

Collaborators

Swiss HIV Cohort Study:
I A Abela, K Aebi-Popp, A Anagnostopoulos, M Battegay, E Bernasconi, D L Braun, H C Bucher, A Calmy, M Cavassini, A Ciuffi, G Dollenmaier, M Egger, L Elzi, J S Fehr, J Fellay, H Furrer, C A Fux, H F Günthard, A Hachfeld, D H U Haerry, B Hasse, H H Hirsch, M Hoffmann, I Hösli, M Huber, D Jackson-Perry, C R Kahlert, O Keiser, T Klimkait, R D Kouyos, H Kovari, K Kusejko, N D Labhardt, K Leuzinger, B Martinez de Tejada, C Marzolini, K J Metzner, N Müller, J Nemeth, D Nicca, J Notter, P Paioni, G Pantaleo, M Perreau, A Rauch, L P Salazar-Vizcaya, P Schmid, O Segeral, R F Speck, M Stöckle, P E Tarr, A Trkola, G Wandeler, M Weisser, S Yerly

Affiliations

¹ University Center for Internal Medicine and Infectious Diseases Service, Kantonsspital Baselland, University of Basel, 4101 Bruderholz, Switzerland.
² Department for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
³ Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
⁴ School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland.
⁵ CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
⁶ Departement of Infectious Diseases, Hvidovre University Hospital, Copenhagen, Denmark.
⁷ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁸ Department of Infectious Diseases, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
⁹ Chair Positive Council, Zürich, Switzerland.
¹⁰ Division of Infectious Diseases, Kantonsspital St Gallen, 9007 St. Gallen, Switzerland.
¹¹ Division of Infectious Diseases, Ente Ospedaliero Cantonale, Lugano, University of Geneva, Geneva, and Università della Svizzera italiana, 6900 Lugano, Switzerland.
¹² Division of Infectious Disease, Geneva University Hospital, 1205 Geneva, Switzerland.
¹³ Bone Unit, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
¹⁴ Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
¹⁵ Institute of Medical Virology, University of Zurich, Zurich, Switzerland.

PMID: 40676878
DOI: 10.1093/cid/ciaf392

Low Trauma Fractures in People with HIV: Longitudinal Time Trends in the Swiss HIV Cohort Study 2009-2022

Isabella C Schoepf et al. Clin Infect Dis. 2025.

. 2025 Jul 17:ciaf392.

doi: 10.1093/cid/ciaf392. Online ahead of print.

Authors

Collaborators

Swiss HIV Cohort Study:
I A Abela, K Aebi-Popp, A Anagnostopoulos, M Battegay, E Bernasconi, D L Braun, H C Bucher, A Calmy, M Cavassini, A Ciuffi, G Dollenmaier, M Egger, L Elzi, J S Fehr, J Fellay, H Furrer, C A Fux, H F Günthard, A Hachfeld, D H U Haerry, B Hasse, H H Hirsch, M Hoffmann, I Hösli, M Huber, D Jackson-Perry, C R Kahlert, O Keiser, T Klimkait, R D Kouyos, H Kovari, K Kusejko, N D Labhardt, K Leuzinger, B Martinez de Tejada, C Marzolini, K J Metzner, N Müller, J Nemeth, D Nicca, J Notter, P Paioni, G Pantaleo, M Perreau, A Rauch, L P Salazar-Vizcaya, P Schmid, O Segeral, R F Speck, M Stöckle, P E Tarr, A Trkola, G Wandeler, M Weisser, S Yerly

Affiliations

¹ University Center for Internal Medicine and Infectious Diseases Service, Kantonsspital Baselland, University of Basel, 4101 Bruderholz, Switzerland.
² Department for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
³ Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
⁴ School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland.
⁵ CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
⁶ Departement of Infectious Diseases, Hvidovre University Hospital, Copenhagen, Denmark.
⁷ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁸ Department of Infectious Diseases, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
⁹ Chair Positive Council, Zürich, Switzerland.
¹⁰ Division of Infectious Diseases, Kantonsspital St Gallen, 9007 St. Gallen, Switzerland.
¹¹ Division of Infectious Diseases, Ente Ospedaliero Cantonale, Lugano, University of Geneva, Geneva, and Università della Svizzera italiana, 6900 Lugano, Switzerland.
¹² Division of Infectious Disease, Geneva University Hospital, 1205 Geneva, Switzerland.
¹³ Bone Unit, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
¹⁴ Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
¹⁵ Institute of Medical Virology, University of Zurich, Zurich, Switzerland.

PMID: 40676878
DOI: 10.1093/cid/ciaf392

Abstract

Background: People with HIV are at increased risk of low trauma fractures (LTFs). Published data on LTF incidence trends over time has not been uniform. This study sought to analyze LTF time trends in the Swiss HIV Cohort Study (SHCS) 2009-2022.

Methods: Fractures are prospectively captured in the SHCS. Since 2008, using a standardized form, each fracture and its low trauma nature was validated by the treating HIV physician and the main investigators. Applying negative binomial regression, we estimated the LTF incidence rate ratio per calendar year univariably and adjusting for time-updated clinical and HIV-related risk factors, plus a genome-wide polygenic risk score associated with bone mineral density.

Results: Between 2009 and 2022, 7524 SHCS participants accumulated 71983 participant-years of observation and 235 validated LTFs, for a LTF incidence of 0.33 (95% confidence interval [CI], 0.29-0.37) per 100 participant-years. There were statistically significant changes over time in multiple demographic, clinical and HIV-related variables potentially associated with better bone health. The LTF incidence rate declined 9.2% (95%CI, 5.6-12.6%) per year on average in univariable analysis and by 7.5% (95%CI, 2.9-11.9%) per year in the full multivariable model. Declining LTF time trends were noted in men and women, younger and older age groups, and participants with favorable and unfavorable genetic background.

Conclusion: LTFs have considerably decreased in people with HIV in Switzerland over a 14-year period. The LTF decline likely is multifactorial and occurred concomitant with favorable trends in ART, demographic and lifestyle variables that may contribute to better bone health.

Keywords: HIV infection; aging; longitudinal time trends; low trauma fractures; multivariable analysis.

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Low Trauma Fractures in People with HIV: Longitudinal Time Trends in the Swiss HIV Cohort Study 2009-2022

Collaborators

Affiliations

Low Trauma Fractures in People with HIV: Longitudinal Time Trends in the Swiss HIV Cohort Study 2009-2022

Authors

Collaborators

Affiliations

Abstract

LinkOut - more resources

Full Text Sources

Miscellaneous