Response to: ‘Does the prevalence of radiographic hand osteoarthritis in patients with HIV-1 infection increase or not?’ by Luo et al

The Framingham Study has been used as a group representative of the general population in many previous studies including in recent lupus studies. 3 4 Moreover, the comparison between the two groups (w/o MetS) within the METAFIB-OA cohort took into account the main risk factors of HOA previously identified such as age, sex and previous joint injury. Since sex and age have a strong impact on HOA occurrence, we chose to stratify all the analyses according to these two parameters. Additionally, one of the readers has previously confirmed her reliability with another expert in the reading of hand radiographs. 9 Moreover, our definition of radiographic HOA was more stringent than that used in Framingham 6 and thus we may have actually underestimated the difference of prevalence of HOA between populations. [...]we confirm that the prevalence of HOA in our cohort of HIV-infected individuals was more frequent than in a control population and linked to the presence of MetS, which is at present frequently observed in ageing HIV-infected individuals. 10