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Comparison between the gold standard DXA with calcaneal quantitative ultrasound based-strategy (QUS) to detect osteoporosis in an HIV infected cohort
Roldan, Eugenia Quiros; Brianese, Nigritella; Raffetti, Elena; Focà, Emanuele; Pezzoli, Maria Chiara; Bonito, Andrea; Ferraresi, Alice; Lanza, Paola; Porcelli, Teresa; Castelli, Francesco.
  • Roldan, Eugenia Quiros; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
  • Brianese, Nigritella; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
  • Raffetti, Elena; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
  • Focà, Emanuele; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
  • Pezzoli, Maria Chiara; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
  • Bonito, Andrea; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
  • Ferraresi, Alice; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
  • Lanza, Paola; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
  • Porcelli, Teresa; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
  • Castelli, Francesco; University of Brescia and Spedali Civili General Hospital. University Department of Infectious and Tropical Diseases. Brescia. IT
Braz. j. infect. dis ; 21(6): 581-586, Nov.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-888924
ABSTRACT
ABSTRACT

Introduction:

Osteoporosis represents one of the most frequent comorbidity among HIV patients. The current standard method for osteoporosis diagnosis is dual-energy X-ray absorptiometry. Calcaneal quantitative ultrasound can provide information about bone quality. The aims of this study are to compare these two methods and to evaluate their ability to screen for vertebral fracture.

Methods:

This cross-sectional study was conducted in HIV patients attending the Clinic of Infectious and Tropical Diseases of Brescia during 2014 and who underwent lumbar/femoral dual-energy X-ray absorptiometry, vertebral fracture assessment and calcaneal quantitative ultrasound. The assessment of osteoporosis diagnostic accuracy was performed for calcaneal quantitative ultrasound and for vertebral fracture comparing them with dual-energy X-ray absorptiometry.

Results:

We enrolled 73 patients and almost 48% of them had osteoporosis with at least one of the method used. Vertebral fracture were present in 27.4%. Among patients with normal bone measurements, we found vertebral fracture in proportion between 10% and 30%. If we used calcaneal quantitative ultrasound method and/or X-ray as screening, the percentages of possible savable dual-energy X-ray absorptiometry ranged from 12% to 89% and misclassification rates ranged from 0 to 24.6%. A combined strategy, calcaneal quantitative ultrasound and X-Ray, identified 67% of patients with low risk of osteoporosis, but 16.4% of patients were misclassified.

Conclusions:

We observed that patients with osteoporosis determined by calcaneal quantitative ultrasound and/or dual-energy X-ray absorptiometry have higher probability to undergo vertebral fracture, but neither of them can be used for predicting vertebral fracture. Use of calcaneal quantitative ultrasound for screening is a reasonable alternative of dual-energy X-ray absorptiometry since our study confirm that none strategy is clearly superior, but both screen tools must be always completed with X-ray.
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Full text: Available Index: LILACS (Americas) Main subject: Osteoporosis / Calcaneus / Absorptiometry, Photon / HIV Infections / Ultrasonography Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2017 Type: Article Affiliation country: Italy Institution/Affiliation country: University of Brescia and Spedali Civili General Hospital/IT

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Full text: Available Index: LILACS (Americas) Main subject: Osteoporosis / Calcaneus / Absorptiometry, Photon / HIV Infections / Ultrasonography Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2017 Type: Article Affiliation country: Italy Institution/Affiliation country: University of Brescia and Spedali Civili General Hospital/IT