Graham, Simon Matthew, Maqungo, Sithombo, Laubscher, Maritz, Ferreira, Nando, Held, Michael, Harrison, William James, Simpson, A Hamish, MacPherson, Peter ORCID: https://orcid.org/0000-0002-0329-9613 and Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200 (2021) 'Fracture Healing in Patients With HIV in South Africa: A Prospective Cohort Study'. JAIDS: Journal of Acquired Immune Deficiency Syndromes, Vol 87, Issue 5, pp. 1214-1220.
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Abstract
Background:
Human immunodeficiency virus (HIV) reduces bone mineral density, mineralisation and turnover, and may impair fracture healing.
Setting:
This prospective cohort study in South Africa investigated whether HIV infection was associated with impaired fracture healing following trauma.
Methods:
All adults with acute tibia and femur fractures who underwent intermedullary nailing (IM) for fracture fixation between September 2017 and December 2018, at two tertiary hospitals, were followed for a minimum of 12 months post-operatively. The primary outcome was delayed bone union at 6 months (defined by the radiological union scoring system for the tibia [RUST] score <9), and the secondary outcome was non-union (defined as RUST score <9) at 9 months. Multivariable logistic regression models were constructed to investigate associations between HIV status and impaired fracture healing.
Results:
In total, 358 participants, who underwent 395 IM nailings, were enrolled in the study and followed up for 12 months. Seventy-one participants (71/358, 19·8%) were HIV positive (83 IM nailings [83/395], 21.0%). HIV was not associated with delayed fracture healing after IM nailing of the tibia or femur (multivariable odds ratio [OR]: 1·06; 95% confidence interval [CI]: 0·50–2·22). Participants with HIV had a statistically significant lower odds of non-union compared to HIV-negative participants (multivariable OR: 0·17; 95% CI: 0·01–0·92).
Conclusions:
Fractures sustained in HIV-positive individuals can undergo surgical fixation as effectively as those in individuals who are HIV negative, with no increased risk of delayed union or non-union.
Item Type: | Article |
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Subjects: | WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.5 Complications WE Musculoskeletal System > WE 100 General works |
Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW) |
Digital Object Identifer (DOI): | https://doi.org/10.1097/QAI.0000000000002720 |
Depositing User: | Stacy Murtagh |
Date Deposited: | 18 May 2021 11:34 |
Last Modified: | 06 Oct 2023 13:28 |
URI: | https://archive.lstmed.ac.uk/id/eprint/17881 |
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