ABSTRACT
Avascular necrosis (AVN) of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipidemia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia) and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.
Subject(s)
Anti-HIV Agents/adverse effects , Femur Head Necrosis/etiology , HIV Infections/complications , HIV Protease Inhibitors/adverse effects , Hypercholesterolemia/complications , Hypertriglyceridemia/complications , Anti-HIV Agents/therapeutic use , Case-Control Studies , Female , Femur Head Necrosis/blood , HIV Infections/drug therapy , HIV Protease Inhibitors/therapeutic use , Humans , Male , Risk FactorsABSTRACT
Avascular necrosis (AVN) of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipidemia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia) and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.
Subject(s)
Female , Humans , Male , Anti-HIV Agents/adverse effects , Femur Head Necrosis/etiology , HIV Infections/complications , HIV Protease Inhibitors/adverse effects , Hypercholesterolemia/complications , Hypertriglyceridemia/complications , Anti-HIV Agents/therapeutic use , Case-Control Studies , Femur Head Necrosis/blood , HIV Infections/drug therapy , HIV Protease Inhibitors/therapeutic use , Risk FactorsABSTRACT
The haematological indices in 50 patients with homozygous sickle cell (SS) disease and avascular necrosis of the femoral head and in 180 patients with SS disease without this complication have been compared. Avascular necrosis of the femoral head was significantly associated with high total levels and with low fetal haemoglobin levels. Low fetal haemoglobin levels are associated with increased intravascular sickling. These results suggest that both intravascular sickling and the increased viscosity associated with high haemoglobin levels are related to the development of avascular necrosis of the femoral head in SS disease. (AU)