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L. Gazzola, L. Comi, A. Savoldi, L. Tagliabue, A. Del Sole, L. Pietrogrande, T. Bini, A. d'Arminio Monforte, G. Marchetti, Use of the FRAX Equation as First-Line Screening of Bone Metabolism Alteration in the HIV-Infected Population, The Journal of Infectious Diseases, Volume 202, Issue 2, 15 July 2010, Pages 330–331, https://doi.org/10.1086/653584
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To the Editor—We read with interest the article by Calmy et al [1], who investigated bone mineral density (BMD) in the human immunodeficiency virus (HIV)–infected population. To our knowledge, this paper provides the first evaluation of the 10-year fracture risk in HIV-positive patients through use of the FRAX equation.
FRAX is a computer-based algorithm that provides the 10-year probability of fractures in men and women on the basis of classic risk factors (CRFs) alone or by integration of CRFs with BMD, which is measured by dual-energy x-ray absorptiometry (DXA) [2]. After the assessment of fracture risk by use of CRFs alone, the patient can be classified to be at low, intermediate, or high risk, on the basis of thresholds defined by the National Osteoporosis Guideline Group. According to these guidelines, patients at low risk have no indication for further analysis, patients at intermediate risk should have their BMD measured and reassess the risk to evaluate the opportunity for treatment, and patients at high risk should be considered directly for treatment with or without BMD assessment [3,4].
