[Influence of anitiretroviral therapy on bone tissue metabolism in patients with HIV]

The use of antiretroviral therapy has resulted in reduction in HIV related morbidity and mortality but antiretroviral treatment have been associated with long term toxicities. High prevalence of premature osteopenia, osteoporosis and osteonecrosis have been recently detected in patients infected with HIV. The pathogenesis of this bone disorders is still unclear and probably multifactoral. Earlier studies have implicated specific antiretroviral medications as causative factors in the development of osteopenia. Patients not receiving antiretrovirals also have a higher than expected prevalence of reduced BMD, which suggests that HIV itself may be a contributing factor, mediated by immune activation and cytokines. Improved understanding of the pathogenesis of these bone disorders should result in better prevention and treatment.