Bone disorders associated with the human immunodeficiency virus: pathogenesis and management

Area of Science:

• Bone Metabolism and Infectious Diseases
• Human Immunodeficiency Virus (HIV) Research

Background:

• Bone disorders including osteopenia, osteoporosis, and osteonecrosis are observed in patients with human immunodeficiency virus (HIV).
• The exact causes and mechanisms behind these bone conditions in HIV-infected individuals remain unclear.
• Prevalence varies significantly, potentially due to factors like antiretroviral therapy, lipodystrophy, HIV disease severity, and co-existing bone loss risks.

Purpose of the Study:

• To review the current understanding of bone disorders in HIV-infected patients.
• To highlight the importance of identifying and managing risk factors for bone loss.
• To discuss current and potential management strategies for these conditions.

Main Methods:

• Literature review and synthesis of existing studies on bone disorders in HIV.
• Analysis of factors influencing prevalence and risk.
• Evaluation of diagnostic and therapeutic approaches.

Main Results:

• Etiology and mechanisms of HIV-associated bone disorders are not fully understood.
• Risk factors such as smoking, alcohol intake, and nutritional deficiencies (calcium, vitamin D) are significant.
• Dual-energy X-ray absorptiometry (DXA) is recommended for assessing bone density in at-risk HIV patients.

Conclusions:

• Proactive management of modifiable risk factors is essential for preventing osteopenia and osteoporosis in HIV patients.
• Bisphosphonates with calcium and vitamin D supplementation show potential for treating osteoporosis.
• Surgical intervention is currently the sole option for managing symptomatic osteonecrosis.