Osteopenia and osteoporosis in people living with HIV: multiprofessional approach

Area of Science:

• Endocrinology
• Infectious Diseases
• Bone Metabolism

Background:

• HIV infection is increasingly recognized as a significant risk factor for bone mineralization disorders.
• Abnormalities in bone mineralization among people living with HIV (PLWHIV) stem from complex interactions involving host factors, the virus itself, and antiretroviral therapies.
• Osteoporosis diagnosis relies heavily on bone mineral density (BMD) measurements, typically via dual-energy X-ray absorptiometry (DXA).

Purpose of the Study:

• To review the factors contributing to bone mineralization abnormalities in PLWHIV.
• To outline current diagnostic and therapeutic strategies for osteoporosis in this population.
• To discuss the potential role of physical activity in managing bone health among PLWHIV.

Main Methods:

• Literature review of factors contributing to bone disease in PLWHIV.
• Analysis of current diagnostic standards for osteoporosis (DXA).
• Summary of pharmacological treatments including calcium/vitamin D, antiresorptives, bone-forming agents, and mixed-action drugs.

Main Results:

• Antiresorptive medications demonstrate the strongest evidence base for osteoporosis treatment efficacy.
• Calcium and vitamin D supplementation may mitigate fracture risk.
• Preliminary data suggests physical activity's potential benefits for bone health in PLWHIV, though more research is needed.

Conclusions:

• HIV infection necessitates careful monitoring and management of bone health due to increased osteoporosis risk.
• Established osteoporosis treatments are effective, with antiresorptive drugs being a cornerstone.
• Further investigation into the specific benefits and implementation of physical activity for bone health in PLWHIV is warranted.