Li K, Ma R, Xu B, Zhang Q. Osteonecrosis of the Femoral Head in People Living With Human Immunodeficiency Virus: A Micro-Computed Tomography Study.
Open Forum Infect Dis 2024;
11:ofad660. [PMID:
38250200 PMCID:
PMC10798855 DOI:
10.1093/ofid/ofad660]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Background
The incidence of osteonecrosis of the femoral head (ONFH) in people with human immunodeficiency virus (HIV) is 10-100 times higher than that in the general population. However, the specific bone microstructure and extent of damage within the femoral head in PWH are still unclear.
Methods
Femoral head samples were obtained by total hip arthroplasty, micro-computed tomography (micro-CT) was employed to investigate the microstructure of trabecular bone across 4 representative regions within necrotic femoral heads, and quantitative analysis was performed.
Results
On general observation, different degrees of degenerative cartilage, fibrocartilage, hyperplastic bone, and exposed bone were presented alternately, with a "map-like" appearance. On micro-CT, compared with the normal and necrotic areas, the bone volume/tissue volume and bone mineral density of the sclerotic areas were significantly increased, the number of trabeculae was significantly increased, and the gap was smaller (P < .05). There was no significant difference in trabecular thickness among the groups (P < .05).
Conclusions
The systemic immune syndrome caused by HIV itself may interfere with the normal metabolism of bone, including osteoblasts and osteoclasts, and thus participate in HIV-related ONFH.
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