High prevalence of osteoporosis among virally suppressed older people (≥60 years) living with <scp>HIV</scp>
Bibliographic record
Abstract
Abstract Objectives Our objective was to evaluate bone mineral density (BMD) among older people living with HIV at the time of enrolment into a clinical trial in Kenya. Methods The bictegravir/emtricitabine/tenofovir alafenamide (BFTAF) Elderly Study is a clinical trial among virally suppressed people living with HIV aged ≥60 years randomized to switch to BFTAF or continue their pre‐enrolment regimen. At enrolment, dual‐energy x‐ray absorptiometry (DXA) of the lumbar spine, total hip, and femoral neck was performed and T‐scores calculated for BMD. Osteoporosis was defined as T‐score −2.5 or lower and osteopenia as T‐score between −1 and −2.5. Fracture risk was calculated based on clinical risk factors (not including BMD), considering HIV as a secondary cause of osteoporosis, and the correlation between FRAX®‐HIV and BMD assessed. Results Between February and May 2022, a total of 296 participants were enrolled. All were Black African, 147 (49.7%) were female, the median age was 64 years (range 60–77), and 280 (94.6%) were on tenofovir disoproxil fumarate. The median BMD of lumbar spine, total hip, and femoral neck was 0.87 g/cm 2 (interquartile range [IQR] 0.78–0.99), 0.89 g/cm 2 (IQR 0.79–1.01), and 0.75 g/cm 2 (IQR 0.67–0.84), respectively, with median T‐scores of −1.9 (IQR −2.8 to −0.7), −1.0 (IQR −1.9 to −0.3), and −1.5 (IQR −2.2 to −0.9), respectively. Osteoporosis and osteopenia were found in 37.5% and 47.3% of participants, respectively. Major osteoporotic fracture and hip fracture 10‐year median probabilities using FRAX®‐HIV were 3.4% (IQR 2.8–4.6) and 1.0% (IQR 0.7–1.3). Correlation coefficients between these FRAX®‐HIV probabilities and femoral neck BMD were −0.204 for major osteoporotic fracture and −0.338 for hip fracture. Conclusions The prevalence of osteoporosis is high among older people living with HIV in Kenya, where DXA is not readily available and risk calculation without BMD had low correlation with measured BMD values. Additional data are required on the impact of investment in fracture risk assessment and treatment, including population‐specific risk calculators.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".