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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Protecting bone in long-term HIV positive patients receiving antiretrovirals
Tara McGinty1, Patrick Mallon1
1a School of Medicine , University College Dublin , Dublin , Ireland.
Insights
Maintaining bone health is crucial for aging individuals with HIV, as they face higher risks of low bone mineral density (BMD) and fractures. This review covers strategies for screening and managing bone health in this population.
Area of Science:
- Bone health in aging populations
- HIV medicine
- Gerontology
Background:
- Aging individuals with HIV experience increased non-AIDS morbidities.
- Low bone mineral density (BMD) and fractures are more prevalent in the HIV-positive population.
- Fragility fractures are a significant cause of morbidity and mortality in people with HIV.
Purpose of the Study:
- To review strategies for maintaining bone health in people living with HIV.
- To discuss screening and management of low BMD and fractures.
- To explore the role of antiretroviral therapy in bone health.
Main Methods:
- Literature review of current strategies.
- Analysis of the impact of antiretroviral therapy on bone health.
- Discussion of expert commentary and future perspectives.
Main Results:
- Increased fracture rates and low BMD are observed in people with HIV.
- Antiretroviral therapy choice and modification can impact bone health.
- Comprehensive management strategies are needed for bone health in aging HIV patients.
Conclusions:
- Proactive management of bone health is essential for people aging with HIV.
- Screening and intervention for low BMD and fracture prevention are critical.
- Further research into optimizing bone health in the context of HIV and aging is warranted.
Introduction:
As the population of people living with HIV ages, the increase in non-AIDs morbidities is expected to increase in parallel. Maintaining bone health in those with HIV will be an important area of focus for the HIV clinician to prevent the morbidity and mortality associated with fragility fractures, the principal clinical sequela of low bone mineral density (BMD). Rates of fractures and prevalence of low bone mineral density, a risk factor for future fragility fractures, are already increased in the HIV positive population.
Areas Covered:
This review examines the strategies to maintain bone health in those living with HIV from screening through to managing those with established low BMD or fracture, including the role for choice of or modification of antiretroviral therapy to maintain bone health. Expert commentary: The increasing complexity of managing bone health in the age of succesful antiretroviral therapy and an aging patient population as well as future perspectives which may help achieve the long term aim of minimising the impact of low BMD in those with HIV are discussed and explored.
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