📢 Publish Your Research for Free - Full APC Waiver, No Hidden Charges. Submit Your Article Today! Submit Now →
JImage

ARTICLE TYPE : RESEARCH ARTICLE

Published on :   12 Dec 2025, Volume - 1
Journal Title :   WebLog Journal of Orthopaedics | WebLog J Orthop
Source URL:   weblog iconhttps://weblogoa.com/articles/wjor.2025.l1202
Permanent Identifier (DOI) :  doi iconhttps://doi.org/10.5281/zenodo.17993813

Femur Fracture Risk in HIV-Positive Patients with End Stage Renal Disease: A Comparative Analysis from 2004 2013 to 2014–2023

Keleb Mehari 1
Damon Ross 1
Justin Morrison 1
Ryan Mitchell 1
Rawan Elkomi 1
Syed Fahad Gillani 2
Samrawit Zinabu 2
Mekdem Bisrat 2 *
Miriam Michael 2
1College of Medicine, Howard University, Washington, DC, USA
2Department of Internal Medicine, Howard University Hospital, Washington, DC, USA

Abstract

Background: While femur fractures typically affect the elderly, HIV-positive patients with end stage renal disease (ESRD) are at an accelerated risk due to prolonged antiretroviral therapy (ART) use and bone loss. The combined impact of these factors on fracture trends remains under-explored.

Objective: To evaluate the association between femur fractures and the coexistence of HIV and ESRD, and to analyze trends in fracture incidence and prevalence from 2004–2013 to 2014–2023 by age, sex, and race.

Methods: This retrospective cohort study used the TriNetX database to analyze data from 2,429 patients with HIV and ESRD receiving ART. The cohort was divided into two time periods: 2004 2013 and 2014–2023. Chi-square tests and Poisson regression were used to assess differences in fracture incidence and prevalence.

Results: Femur fracture incidence increased from 1.52% to 2.61% (a 71% increase), while prevalence grew from 1.67% to 3.80% (a 127% increase). This rise was most pronounced in females, with incidence increasing from 1.53% to 3.24% versus 1.84% to 2.25% in males. Racial disparities were also observed, with incidence in Asian patients rising from 0.0% to 45.45% and in Black or African American patients from 1.42% to 2.1%. The increase in fractures was also evident in younger patients.

Conclusion: The incidence of femur fractures in HIV-positive ESRD patients has significantly increased, with fractures occurring at earlier ages and disproportionately impacting women and certain racial minorities. These findings underscore the urgent need for early and routine bone health screening and tailored prevention strategies in this vulnerable population.

Keywords: HIV; End-Stage Renal Disease; Femur Fracture; Antiretroviral Therapy; Bone Fragility

Citation

Mehari K, Ross D, Morrison J, xMitchell J, Elkomi R, Gillani SF, et al. Femur Fracture Risk in HIV-Positive Patients with End-Stage Renal Disease: A Comparative Analysis from 2004–2013 to 2014–2023. WebLog J Orthop. wjor.2025.l1202. https://doi.org/10.5281/zenodo.17993813
Read Full Article