Bone disorders in human immunodeficiency virus infection.

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.