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Bone disorders in human immunodeficiency virus infection

Marshall J Glesby1

  • 1Division of International Medicine and Infectious Diseases, Department of Medicine, Weill Medical College of Cornell University, New York, New York 10021, USA. mag2005@med.cornell.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 28, 2003
PubMed

Insights

Human immunodeficiency virus (HIV) infection is linked to significant bone disorders like osteopenia and osteoporosis, impacting bone mineral density (BMD). Further research is needed to understand fracture risks and develop interventions for HIV patients.

Area of Science:

  • Bone metabolism and virology
  • Immunology and infectious diseases

Background:

  • Human immunodeficiency virus (HIV) infection is associated with significant bone disorders, including osteopenia, osteoporosis, and osteonecrosis.
  • A high prevalence of reduced bone mineral density (BMD) is observed in HIV-infected patients, even those not on antiretroviral therapy, suggesting HIV itself contributes via immune activation.

Purpose of the Study:

  • To summarize the current understanding of bone disorders in HIV-infected patients.
  • To highlight the prevalence of reduced BMD and increasing incidence of osteonecrosis.
  • To identify gaps in knowledge regarding fracture risk and therapeutic interventions.

Main Methods:

  • Review of existing literature on bone disorders in HIV infection.
  • Analysis of data on bone mineral density (BMD) in treated and untreated HIV patients.
  • Examination of reported cases and risk factors for osteonecrosis in HIV-infected individuals.

Main Results:

  • HIV-infected patients, both on and off antiretroviral therapy, exhibit a high prevalence of reduced bone mineral density (BMD).
  • The incidence of osteonecrosis in HIV patients appears to be increasing, with corticosteroid use identified as a significant risk factor.
  • Controlled studies have not substantiated a link between protease inhibitors and increased osteonecrosis risk.

Conclusions:

  • HIV infection itself, through immune activation, contributes to bone density loss.
  • Further research is crucial to define fracture risks and develop effective interventions for bone health in HIV patients.
  • Understanding the pathogenesis of these bone disorders is essential for improved prevention and treatment strategies.

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