Table 1.
Characteristics of Participants With Avascular Bone Necrosis and Controls
| Baseline Characteristics | Total (n = 219) |
Cases With AVN (n = 74) |
Controls (n = 145) |
P Value |
|---|---|---|---|---|
| Sex | ||||
| Male, n (%) | 162 (74) | 55 (74) | 107 (74) | naa |
| Registration date in SHCS, median year (IQR) | 1996 (1991–1999) | 1996 (1991–1999) | 1996 (1991–1999) | naa |
| Follow-up until diagnosis of AVN, median (IQR), y | 8.3 (4.0–15) | 8.5 (3.8–15) | 8.1 (4.2–15) | naa |
| Race | ||||
| White, n (%) | 200 (91) | 66 (89) | 134 (92) | .44 |
| HIV transmission risk group | .003 | |||
| Men who have sex with men, n (%) | 94 (43) | 22 (30) | 72 (50) | |
| Heterosexual, n (%) | 61 (28) | 27 (36) | 34 (23) | |
| Injection drug use, n (%) | 64 (29) | 25 (34) | 39 (27) | |
| Age at diagnosis of AVN, median (IQR), y | 45 (38–53) | 42 (37–52) | 46 (38–53) | .29 |
| Year of diagnosis | .66 | |||
| <1997, n (%) | 12 (5.5) | 4.0 (5.4) | 8.0 (5.5) | |
| 1997–2002, n (%) | 55 (25) | 20 (27) | 35 (24) | |
| >2002, n (%) | 152 (69) | 50 (68) | 102 (70) | |
| Smoking | .08 | |||
| <20 pack-years, n (%) | 118 (54) | 34 (46) | 84 (58) | |
| ≥20 pack-years, n (%) | 101 (46) | 40 (54) | 61 (42) | |
| BMI at diagnosis of AVN, median (IQR), kg/m2 | 24 (23–25) | 24 (23–25) | 24 (23–25) | .72 |
| Alcohol consumption | .001 | |||
| None/light, n (%) | 150 (68) | 40 (54) | 110 (76) | |
| Moderate/severe, n (%) | 69 (32) | 34 (46) | 35 (24) | |
| Comorbidities | ||||
| Diabetes mellitus, n (%) | 19 (8.7) | 5.0 (6.8) | 14 (9.7) | .445 |
| Hypertension, n (%) | 64 (29) | 20 (27) | 44 (30) | .62 |
| Hyperlipidemia, n (%) | 164 (75) | 64 (86) | 100 (69) | .002 |
| Pancreatitis, n (%) | 9.0 (4.1) | 6.0 (8.0) | 3.0 (2.0) | .05 |
| Pulmonary embolism/deep venous thrombosis, n (%) | 18 (8.2) | 8.0 (11) | 10 (6.9) | .308 |
| Radiation therapy, n (%) | 9.0 (4.1) | 2.0 (2.7) | 7.0 (4.8) | .49 |
| Haemodialyis, n (%) | 0.0 (0.0) | 0.0 (0.0) | 0.0 (0.0) | na |
| Collagenosis, n (%) | 0.0 (0.0) | 0.0 (0.0) | 0.0 (0.0) | na |
| Sickle cell anemia, n (%) | 0.0 (0.0) | 0.0 (0.0) | 1 .0 (1.0) | na |
| Co-infections | ||||
| CMV-seropositive, n (%) | 169 (79) | 56 (76) | 113 (80) | .441 |
| Toxoplasmosis-seropositive, n (%) | 91 (43) | 30 (41) | 61 (44) | .69 |
| HBs-Ag positive, n (%) | 16 (7.6) | 7.0 (9.7) | 9.0 (6.5) | .289 |
| HCV seropositive, n (%) | 73 (33) | 28 (38) | 45 (31) | .361 |
| Comedications | ||||
| Corticosteroid use, n (%) | 60 (27) | 24 (32) | 36 (25) | .23 |
| Corticosteroid use >3 mo, n (%) | 17 (7.8) | 11 (15) | 6.0 (4.1) | .009 |
| Testosterone/anabolics use, n (%) | 12 (5.5) | 2.0 (2.7) | 10 (6.9) | .24 |
| Megestrol acetate use, n (%) | 0.0 (0.0) | 0.0 (0.0) | 0.0 (0.0) | na |
| AIDS at diagnosis of AVN, n (%) | 71 (32) | 30 (41) | 41 (28) | .093 |
| CD4+ T-cell count | ||||
| CD4 count at diagnosis of AVN, median (IQR), cells/uL | 431 (295–587) | 398 (259–547) | 460 (329–610) | .33 |
| CD4 nadir, median (IQR), cells/uL | 141 (57–250) | 117 (38–200) | 160 (70–265) | .20 |
| CD4 nadir <200 cells/uL, n (%) | 144 (66) | 55 (74) | 89 (61) | .05 |
| HIV-RNA | ||||
| HIV RNA at diagnosis of AVN below detection limit, n (%) | 140 (66) | 45 (63) | 95 (67) | .49 |
| RNA first value, median (IQR), log10 RNA | 4.5 (3.7–5.1) | 4.5 (3.5–5.2) | 4.5 (3.8–5.0) | .52 |
| RNA maximum value, median (IQR), log10 RNA | 5.0 (4.3–5.4) | 5.1 (4.5–5.7) | 5.0 (4.3–5.2) | .17 |
| RNA AUC, median (IQR), log10 copy-years | 40 (24–60) | 43 (25–62) | 39 (24–58) | .89 |
| HIV treatment | ||||
| Duration of HIV infection at diagnosis of AVN, median (IQR), y | 13 (6.2–19) | 13 (5.6–19) | 13 (7.2–19) | .07 |
| Duration of untreated HIV infection at diagnosis of AVN, median (IQR), y | 6.4 (1.5–10) | 6.1 (1.1–9.7) | 6.8 (1.9–11) | .34 |
Alcohol use: severe (female >40 g/d, male >60 g/d), moderate (female 20–40 g/d, male 40–60 g/d), light (female <20 g/d, male <40 g/d). Hyperlipidemia: cholesterol >5 mmol/L and/or triglyceride >2 mmol/L.
Abbreviations: 3TC, lamivudin; ABC, abacavir; ART, antiretroviral treatment; ATV, atazanavir; AVN, avascular necrosis; AZT, zidovudine; d4T, stavudin; DDI, didanosin; DRV, darunavir; EFV, efavirenz; ETC, emtricitabine; FI, fusion inhibitor; HIV, human immunodeficiency virus; IDV, indinavir; IQR, interquartile range; LPV, lopinavir; NFV, nelfinavir; NNRTI, non-nucleoside reverse transcriptase inhibitor; NRTI, nucleoside reverse transcriptase inhibitor; NVP, nevirapine; PI, protease inhibitor; RGV, raltegravir; RNA, ribonucleic acid; RTV, ritonavir; SQV, saquinavir; TDF, tenofovir.
aWe did not analyze factors that were matched on.