Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

HIV/HCV Coinfection & Osteoporotic Fracture Risk

Clin Infect Dis; ePub 2017 Nov 14; Bedimo, et al

Hepatitis C virus (HCV) infection is associated with micro-architectural changes at the lumbar spine, suggesting that microstructural abnormalities underlie some of the higher fracture risk in HCV infection. This according to a prospective, cross-sectional cohort study of virologically suppressed HIV, untreated HCV, HIV/HCV coinfected, and non-infected controls. The study included 532 male participants: 57 HIV/HCV, 174 HIV, 123 HCV, and 178 controls. Researchers conducted analysis of covariance comparing bone mineral density (BMD) and trabecular bone score (TBS) between groups, controlling for age, race, body mass index (BMI), and smoking. They found:

  • Both HIV and HCV were associated with decreased BMD, but only HCV, not HIV, was associated with lower TBS score.
  • Participants with HIV/HCV coinfection had lower TBS scores than HIV mono-infected and uninfected participants.
  • Neither the use of tenofovir, HCV viremia, nor the severity of HCV liver disease were associated with lower TBS.


Bedimo RJ, Adams-Huet B, Poindexter J, et al. The differential effects of HIV and HCV on bone micro-architecture and fracture risk. [Published online ahead of print November 14, 2017]. Clin Infect Dis. doi:10.1093/cid/cix1011.

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