Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Feb 4;81(6):e581-e590.
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  1   2 , Vera Baltisberger  1 , Christian W Thorball  3   4 , Lene Ryom  5   6   7 , Gilles Wandeler  8 , David Haerry  9 , Christian R Kahlert  10 , Enos Bernasconi  11   12 , Alexandra Calmy  13 , Olivier Lamy  14 , Jacques Fellay  3   4 , Huldrych F Günthard  15   16 , Bruno Ledergerber  15 , Philip E Tarr  1 ; Swiss HIV Cohort Study
Collaborators, Affiliations

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. .

Abstract

Background: People with human immunodeficiency virus (HIV) are at increased risk of low trauma fractures (LTFs). Published data on LTF incidence trends over time have not been uniform. This study sought to analyze LTF time trends in the Swiss HIV Cohort Study (SHCS) over the time period 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 71 983 participant-years of observation and 235 validated LTFs, for an LTF incidence of 0.33 (95% confidence interval [CI], .29-.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 by 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.

Conclusions: 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 antiretroviral therapy, demographic, and lifestyle variables that may contribute to better bone health.

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

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. P. E. T.'s institution reports grants, advisory fees, or educational fees from Gilead, ViiV, MSD, and Daiichi-Sankyo, outside the submitted work. B. L. received personal fees from Kantonsspital Baselland, Liestal, Switzerland, during the conduct of the study, and reports personal fees from Gilead, outside the submitted work. H. F. G. has received grants from the Swiss National Science Foundation, the SHCS, the Yvonne Jacob Foundation, the National Institutes of Health, Gilead Sciences, ViiV, and Roche; is a subcontractor to a Gates Foundation grant (paid to institution); and reports personal fees from Merck, Gilead Sciences, ViiV, Janssen, GSK, Johnson & Johnson, and Novartis for consultancy or data and safety monitoring board membership. E. B. has received grants from the Swiss National Science Foundation and the SHCS as support for the present study. Outside the submitted work, he received grants from Merck and Gilead; consulting fees from Gilead, Merck, ViiV, Pfizer, Moderna, AstraZeneca, Eli Lilly, and AbbVie; and travel support from Gilead, Merck, ViiV, and Pfizer. All payments were made to his institution. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.