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Avascular
Necrosis (AVN) and HIV--Information for Clinicians
ARA
is currently conducting a pilot retrospective study of the
risk factors underlying the development of avascular necrosis
(AVN) in HIV-infected individuals. The purpose of this study
is to create a database of information on HIV+ patients with
AVN to identify possible HIV-associated risk factors for AVN.
This information will then be provided to the FDA and to pharmaceutical
companies in an effort to motivate further prospective research
into AVN.
In
the general population, a number of risk factors for AVN have
been identified, including steroid use, alcohol dependency,
sickle cell anemia, long bone fractures, dysbaric conditions,
and Gaucher disease, among others. If the apparent recent
increase in the incidence of AVN in HIV-infected patients
is real, then it might be the result of previously unrecognized
risk factors specific for this population. For example, AVN
might be seen more now because of recently developed treatment
options, or because it is a complication of HIV infection
more frequently observed in an era of reduced AIDS-related
mortality. If so, then our study might identify patients for
whom conventionally-accepted risk factors are absent; review
of these cases could provide clues for further investigation.
How
you can get involved
ARA
invites clinicians involved in providing health care to HIV+
individuals to join our effort to learn more about the incidence
of AVN in this patient population. We have initiated a retrospective
chart review study of HIV+ patients diagnosed with AVN. We
ask physicians to fill out a 2-page CRF that asks for information
concerning the patients' medical histories. If you have an
HIV+ patient diagnosed with AVN, please call Corrigan Castro
at 310/358.2429 to receive a copy of the CRF.
ARA
is also hosting an e-mail list server to facilitate communications
between clinicians and scientists working on this problem.
To join, simply e-mail us at avn@aidsresearch.org.
On-line
data submission
Soon
at our web-site (www.aidsresearch.org) the CRF will be available
for on-line data submission.
References
For
a recent review of AVN, we recommend: "Avascular necrosis:
a case history and literature review"
Arch
Fam Med (2000) 9:291-294.
Three
recent case studies of AVN in HIV+ individuals:
- AIDS
(1999) 13:1147-1148.
- AIDS
(1999) 13:1997-1998.
- Abstract
680, 6th Conference on Retroviruses and Opportunistic Infections
(1999).
This
research project has been reviewed and approved by the AIDS
Research Alliance Institutional Review Board.
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