NEW MICROBIOLOGICA, 37, 25-32, 2014 Corresponding author Marco Borderi Infectious Diseases Section Department of Medical and Surgical Sciences University of Bologna, Italy E-mail: marco.borderi@aosp.bo.it INTRODUCTION An increased prevalence of low bone mineral density (BMD), osteopenia and osteoporosis has recently been reported in both men and women with HIV infection and, compared to uninfected individuals, low BMD is more com- mon among HIV-infected subjects (Arnsten et al., 2006; Amiel et al., 2004; Tebas et al., 2000; Bruera et al., 2003; Carr et al., 2001; Moore et al., 2001). SUMMARY Received March 26, 2013 Accepted December 12, 2013 Although the increased prevalence of low bone mineral density among HIV-infected patients has raised concern for increased fracture risk, few investigations have evaluated fracture rates. Increasing evidence indicates that HIV patients are at higher risk of osteoporotic fractures compared to the general population. This is a very important issue, because fragility fractures are complications with a significant prognostic value. Our study performed lateral spine X-ray to assess the prevalence of sub-clinical vertebral fractures in 202 HIV patients. Factors associated with vertebral fractures were also investigated. The prevalence of vertebral fractures was significantly high (23.3%): 14 subjects had SDI (spine deformity in- dex)=1, 22 SDI=2-3 and 11 SDI >4. Differences in the prevalence of vertebral fractures between naïve and ART- experienced patients was 18% vs. 24%, respectively. Furthermore, patients had a high prevalence of severe and multiple fractures; in 19 patients (40%) fractures involved multiple vertebrae. Patients with vertebral fractures were significantly older, with renal insufficiency and steroid use more frequently than subjects with no fractures. Our data suggest that the prevalence of vertebral fractures in HIV infection may be higher than expected, and lateral spine X-ray has a role in the screening of bone disease, at least in patients with a significant risk of fragility fractures. KEY WORDS: HIV infection, Spine X-ray, Vertebral fractures. Prevalence of sub-clinical vertebral fractures in HIV-infected patients Marco Borderi 1 , Leonardo Calza 1 , Vincenzo Colangeli 1 , Elisa Vanino 1 , Pierluigi Viale 1 , Davide Gibellini 2 , Maria Carla Re 2 1 Infectious Disease Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy; 2 Department of Haematology and Oncologic Sciences, Section of Microbiology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. Many recent studies have investigated BMD among patients with HIV infection (Gold et al., 2002; Mondy et al., 2003; Bongiovanni et al., 2005; Cazanave et al., 2008; Rivas et al., 2008), finding have a high prevalence of osteopenia and osteoporosis in HIV-infected compared with control groups (Brown et al., 2004; Dolan et al., 2004; Yin et al., 2005; Dolan et al., 2007; Jones et al., 2007, Brown et al., 2006a). A meta-analysis of studies comparing BMD in HIV-infected with non-HIV-infected patients estimated that 67% of HIV-infected persons had reduced BMD, and 15% had osteoporosis, demonstrating a pooled odds ratio of 3.7 for os- teoporosis (Brown et al., 2006b). Although the increased prevalence of low BMD among HIV-infected patients has raised con- cern for increased fracture risk, few investi-