Fratura vertebral e HIV: revisão sistemática e metanálise
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Manancial - Repositório Digital da UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/21574 |
Resumo: | The survival of HIV-infected patients has increased with the advent of antiretroviral therapy. Consequently, comorbidities uncommon in these population emerged and the skeleton is one o f systems affected. Vertebral fracture is a sign of reduction in bone quality and a hallmark of osteoporosis. This study aims to assess the frequency of spine fractures in HIV-positive men and women aged over 18 years. We performed a systematic review of randomized controlled trials (RCTs), cohort studies, cross-sectional studies, and case-control studies. The study protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42016048702. Studies that have evaluated either morphometric or clinical vertebral fracture were included. The search strategy included the following descriptors: "Spinal Fractures"; "Fractures, Bone"; "HIV"; "Acquired Immunodeficiency Syndrome"; and "Anti-Retroviral Agents" in the databases PubMed, BIREME, EMBASE, and the Cochrane Library. Additionally, some studies were selected from the reference lists of the included articles. We considered studies written in any language and with no publication date limits. Two protocol members independently performed the selection of the studies. Also, two research members also performed the data extraction, separately. Afterward, it was discussed and agreed between both. In total 488 studies were found, of which 90 were excluded due overlap. After the title and abstracts screening, 53 studies remained. Of these, 28 were excluded due to lack of outcome, study design, and redundant publication. A total of 102.744 individuals HIV positive were identified at 26 studies. The metanalysis of the prevalence of vertebral fractures included 14 studies with 10.593 subjects. The prevalence was 12.7% (CI 5.6% to 26.4%). Besides, when we evaluated independently clinical vertebral fracture (n = 5) and morphometric vertebral fracture (n=9), the prevalence was 3.9% (95%CI 0.9% to 15.8%) and 21,1% (95%CI 14,1% to 30.4%) respectively. The metanalysis of the incidence of vertebral fractures included 10 studies with 430589 individuals. The incidence was 0.8 (95% CI 0.4 to 1.8) per 1000 personyears. There was no study of incidence evaluating morphometric fractures. In 9 studies, 56117 HIV-infected patients were compared with 5171132 HIV-uninfected controls. The HIVinfected patients had an odds ratio of 2.3 (95% CI 1.37 to 3.85) when compared with HIVuninfected patients. We did not find association between age and gender and prevalence of vertebral fracture in HIV. In conclusion, the frequency of morphometric vertebral fractures is high in HIV-subjects. Moreover, HIV-positive subjects had a higher chance of vertebral fractures when compared with HIV-negative subjects. |
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Fratura vertebral e HIV: revisão sistemática e metanáliseHIV and vertebral fractures: a systematic review and metanalysisFratura vertebralHIV (Vírus da Imunodeficiência Humana)MetanáliseOsteoporoseSpine fractureMeta-analysisOsteoporosisCNPQ::CIENCIAS BIOLOGICAS::FARMACOLOGIAThe survival of HIV-infected patients has increased with the advent of antiretroviral therapy. Consequently, comorbidities uncommon in these population emerged and the skeleton is one o f systems affected. Vertebral fracture is a sign of reduction in bone quality and a hallmark of osteoporosis. This study aims to assess the frequency of spine fractures in HIV-positive men and women aged over 18 years. We performed a systematic review of randomized controlled trials (RCTs), cohort studies, cross-sectional studies, and case-control studies. The study protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42016048702. Studies that have evaluated either morphometric or clinical vertebral fracture were included. The search strategy included the following descriptors: "Spinal Fractures"; "Fractures, Bone"; "HIV"; "Acquired Immunodeficiency Syndrome"; and "Anti-Retroviral Agents" in the databases PubMed, BIREME, EMBASE, and the Cochrane Library. Additionally, some studies were selected from the reference lists of the included articles. We considered studies written in any language and with no publication date limits. Two protocol members independently performed the selection of the studies. Also, two research members also performed the data extraction, separately. Afterward, it was discussed and agreed between both. In total 488 studies were found, of which 90 were excluded due overlap. After the title and abstracts screening, 53 studies remained. Of these, 28 were excluded due to lack of outcome, study design, and redundant publication. A total of 102.744 individuals HIV positive were identified at 26 studies. The metanalysis of the prevalence of vertebral fractures included 14 studies with 10.593 subjects. The prevalence was 12.7% (CI 5.6% to 26.4%). Besides, when we evaluated independently clinical vertebral fracture (n = 5) and morphometric vertebral fracture (n=9), the prevalence was 3.9% (95%CI 0.9% to 15.8%) and 21,1% (95%CI 14,1% to 30.4%) respectively. The metanalysis of the incidence of vertebral fractures included 10 studies with 430589 individuals. The incidence was 0.8 (95% CI 0.4 to 1.8) per 1000 personyears. There was no study of incidence evaluating morphometric fractures. In 9 studies, 56117 HIV-infected patients were compared with 5171132 HIV-uninfected controls. The HIVinfected patients had an odds ratio of 2.3 (95% CI 1.37 to 3.85) when compared with HIVuninfected patients. We did not find association between age and gender and prevalence of vertebral fracture in HIV. In conclusion, the frequency of morphometric vertebral fractures is high in HIV-subjects. Moreover, HIV-positive subjects had a higher chance of vertebral fractures when compared with HIV-negative subjects.A expectativa de vida dos indivíduos infectados pelo HIV aumentou com o advento da terapia antirretroviral. Consequentemente, comorbidades incomuns nessa população começaram a surgir, sendo o ósseo um dos sistemas afetados. A fratura vertebral é um sinal de redução na qualidade óssea e uma característica da osteoporose. O presente estudo teve como objetivo avaliar a frequência de fratura vertebral em homens e mulheres infectados pelo HIV, com idade superior a 18 anos. Foi realizada uma revisão sistemática a partir de ensaios clínicos randomizados (RCTs), estudos de coorte, estudos transversais e estudos de casocontrole. O protocolo de estudo foi registrado no International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42016048702. Foram incluídos estudos independente da forma de avaliação das fraturas vertebrais: clínicas ou morfométricas. A estratégia de busca incluiu os seguintes descritores: "Spinal Fractures"; "Fractures, Bone"; "HIV"; "Acquired Immunodeficiency Syndrome"; and "Anti-Retroviral Agents" nos bancos de dados PubMed, BIREME, EMBASE e a Cochrane Library. Além disso, alguns estudos foram selecionados a partir das referências dos artigos incluídos. Estudos escritos em qualquer idioma e sem limites de data de publicação foram aceitos. Dois pesquisadores realizaram de forma independente a seleção dos estudos e a extração dos dados. Posteriormente, os resultados obtidos foram discutidos e acordados entre ambos. No total, 488 estudos foram encontrados, dos quais 90 foram excluídos por serem duplicados. Após triagem por títulos e resumos, 53 estudos permaneceram. Desses, 28 foram excluídos por falta de desfecho, delineamento inadequado e publicação redundante. Um total de 85,411 indivíduos HIV positivos foram identificados em 26 estudos. A metanálise da prevalência de fraturas vertebrais incluiu 14 estudos com 10.593 indivíduos. A prevalência foi de 12.7% (IC 5.6% a 26.4%). Ao serem avaliada separadamente as fraturas vertebrais clínicas (n = 5) e as morfométricas (n = 9), a prevalência foi de 3.9% (IC 95%: 0.9 a 15.8) e 21,1% (CI 14,1% a 30.4%), respectivamente. A metanálise de incidência de fraturas vertebrais incluiu 10 estudos, com 430589 indivíduos. A incidência foi de 0.8 (IC 95%: 0.4 a 1.8) por 1000 pessoas-ano. Nenhum estudo de incidência avaliou fraturas morfométricas. Em 9 estudos, 56117 indivíduos infectados pelo HIV foram comparados com 5171132 controles não infectados. Os indivíduos infectados pelo HIV apresentaram odds ratio de 2.3 (IC 95%: 1.37 a 3.85) quando comparados aos não infectados. Não foram encontradas associações entre idade e sexo com prevalência de fratura vertebral no HIV. Concluindo, indivíduos infectados pelo HIV apresentam uma frequência elevada de fraturas vertebrais morfométricas. Esses indivíduos ainda possuem maior chance de fraturas vertebrais quando comparados a pessoas HIV negativas.Universidade Federal de Santa MariaBrasilFarmacologiaUFSMPrograma de Pós-Graduação em FarmacologiaCentro de Ciências da SaúdePremaor, Melissa Orlandinhttp://lattes.cnpq.br/1919693261808995Mello, Carlos Fernando deRodrigues, Ticiana CostaIlha, Thales Augusto de Santa Helena2021-07-22T19:44:34Z2021-07-22T19:44:34Z2017-08-14info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://repositorio.ufsm.br/handle/1/21574porAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSM2021-07-23T06:02:09Zoai:repositorio.ufsm.br:1/21574Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2021-07-23T06:02:09Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.none.fl_str_mv |
Fratura vertebral e HIV: revisão sistemática e metanálise HIV and vertebral fractures: a systematic review and metanalysis |
title |
Fratura vertebral e HIV: revisão sistemática e metanálise |
spellingShingle |
Fratura vertebral e HIV: revisão sistemática e metanálise Ilha, Thales Augusto de Santa Helena Fratura vertebral HIV (Vírus da Imunodeficiência Humana) Metanálise Osteoporose Spine fracture Meta-analysis Osteoporosis CNPQ::CIENCIAS BIOLOGICAS::FARMACOLOGIA |
title_short |
Fratura vertebral e HIV: revisão sistemática e metanálise |
title_full |
Fratura vertebral e HIV: revisão sistemática e metanálise |
title_fullStr |
Fratura vertebral e HIV: revisão sistemática e metanálise |
title_full_unstemmed |
Fratura vertebral e HIV: revisão sistemática e metanálise |
title_sort |
Fratura vertebral e HIV: revisão sistemática e metanálise |
author |
Ilha, Thales Augusto de Santa Helena |
author_facet |
Ilha, Thales Augusto de Santa Helena |
author_role |
author |
dc.contributor.none.fl_str_mv |
Premaor, Melissa Orlandin http://lattes.cnpq.br/1919693261808995 Mello, Carlos Fernando de Rodrigues, Ticiana Costa |
dc.contributor.author.fl_str_mv |
Ilha, Thales Augusto de Santa Helena |
dc.subject.por.fl_str_mv |
Fratura vertebral HIV (Vírus da Imunodeficiência Humana) Metanálise Osteoporose Spine fracture Meta-analysis Osteoporosis CNPQ::CIENCIAS BIOLOGICAS::FARMACOLOGIA |
topic |
Fratura vertebral HIV (Vírus da Imunodeficiência Humana) Metanálise Osteoporose Spine fracture Meta-analysis Osteoporosis CNPQ::CIENCIAS BIOLOGICAS::FARMACOLOGIA |
description |
The survival of HIV-infected patients has increased with the advent of antiretroviral therapy. Consequently, comorbidities uncommon in these population emerged and the skeleton is one o f systems affected. Vertebral fracture is a sign of reduction in bone quality and a hallmark of osteoporosis. This study aims to assess the frequency of spine fractures in HIV-positive men and women aged over 18 years. We performed a systematic review of randomized controlled trials (RCTs), cohort studies, cross-sectional studies, and case-control studies. The study protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42016048702. Studies that have evaluated either morphometric or clinical vertebral fracture were included. The search strategy included the following descriptors: "Spinal Fractures"; "Fractures, Bone"; "HIV"; "Acquired Immunodeficiency Syndrome"; and "Anti-Retroviral Agents" in the databases PubMed, BIREME, EMBASE, and the Cochrane Library. Additionally, some studies were selected from the reference lists of the included articles. We considered studies written in any language and with no publication date limits. Two protocol members independently performed the selection of the studies. Also, two research members also performed the data extraction, separately. Afterward, it was discussed and agreed between both. In total 488 studies were found, of which 90 were excluded due overlap. After the title and abstracts screening, 53 studies remained. Of these, 28 were excluded due to lack of outcome, study design, and redundant publication. A total of 102.744 individuals HIV positive were identified at 26 studies. The metanalysis of the prevalence of vertebral fractures included 14 studies with 10.593 subjects. The prevalence was 12.7% (CI 5.6% to 26.4%). Besides, when we evaluated independently clinical vertebral fracture (n = 5) and morphometric vertebral fracture (n=9), the prevalence was 3.9% (95%CI 0.9% to 15.8%) and 21,1% (95%CI 14,1% to 30.4%) respectively. The metanalysis of the incidence of vertebral fractures included 10 studies with 430589 individuals. The incidence was 0.8 (95% CI 0.4 to 1.8) per 1000 personyears. There was no study of incidence evaluating morphometric fractures. In 9 studies, 56117 HIV-infected patients were compared with 5171132 HIV-uninfected controls. The HIVinfected patients had an odds ratio of 2.3 (95% CI 1.37 to 3.85) when compared with HIVuninfected patients. We did not find association between age and gender and prevalence of vertebral fracture in HIV. In conclusion, the frequency of morphometric vertebral fractures is high in HIV-subjects. Moreover, HIV-positive subjects had a higher chance of vertebral fractures when compared with HIV-negative subjects. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-08-14 2021-07-22T19:44:34Z 2021-07-22T19:44:34Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/21574 |
url |
http://repositorio.ufsm.br/handle/1/21574 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Brasil Farmacologia UFSM Programa de Pós-Graduação em Farmacologia Centro de Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Brasil Farmacologia UFSM Programa de Pós-Graduação em Farmacologia Centro de Ciências da Saúde |
dc.source.none.fl_str_mv |
reponame:Manancial - Repositório Digital da UFSM instname:Universidade Federal de Santa Maria (UFSM) instacron:UFSM |
instname_str |
Universidade Federal de Santa Maria (UFSM) |
instacron_str |
UFSM |
institution |
UFSM |
reponame_str |
Manancial - Repositório Digital da UFSM |
collection |
Manancial - Repositório Digital da UFSM |
repository.name.fl_str_mv |
Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM) |
repository.mail.fl_str_mv |
atendimento.sib@ufsm.br||tedebc@gmail.com |
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1805922178301952000 |