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Bone alterations associated with HIV.

Amy H Warriner1, Michael Mugavero, E Turner Overton

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Current HIV/AIDS Reports
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PubMed
Summary
This summary is machine-generated.

HIV infection and antiretroviral therapy (ART) are linked to lower bone mineral density (BMD) and increased fracture risk in adults and youth. Bisphosphonates are safe and effective for treating bone loss in people with HIV.

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Area of Science:

  • Bone Metabolism and HIV Research
  • Osteoporosis and Public Health

Background:

  • HIV infection and antiretroviral therapy (ART) are associated with reduced bone mineral density (BMD).
  • This bone loss increases fracture risk, particularly concerning for aging individuals with HIV and HIV-infected youth who may not achieve peak BMD.
  • The causes of bone disease in HIV are multifactorial, involving the virus, immunosuppression, ART, and traditional osteoporosis risk factors.

Purpose of the Study:

  • To highlight the association between HIV, ART, and decreased BMD.
  • To emphasize the increased fracture risk in the HIV-positive population.
  • To discuss the challenges in elucidating bone disease causes and recommend management strategies.

Main Methods:

  • Review of current evidence linking HIV infection and ART to bone density and fracture risk.
  • Analysis of contributing factors to bone disease in HIV, including viral, immunological, therapeutic, and lifestyle elements.
  • Evaluation of screening and treatment approaches for osteoporosis in HIV-positive individuals.

Main Results:

  • Consistent association between HIV/ART and decreased BMD, leading to higher fracture risk.
  • Potential failure of HIV-infected children and youth to attain peak BMD, elevating lifetime fracture risk.
  • Bisphosphonate therapy demonstrates safety and efficacy in managing fractures and elevated fracture risk in the HIV+ population.

Conclusions:

  • Healthcare providers must recognize the elevated risk of low BMD and fractures in people with HIV.
  • Appropriate screening for osteoporosis is recommended for HIV-positive patients with risk factors.
  • Bisphosphonates are a safe and effective treatment option for fractures or high fracture risk in this population.