HIV and Bone Complications: Understudied Populations and New Management Strategies

Area of Science:

• Bone Metabolism and HIV Research
• Pharmacology and Bone Health
• Pediatric and Adolescent Health

Background:

• Established link between HIV infection and increased osteoporosis/fracture risk.
• Growing recognition of the need for bone fracture risk assessment in aging HIV populations.
• Antiretroviral therapy (ART) can negatively impact bone mineral density.

Purpose of the Study:

• To review emerging data on bone complications in HIV/HCV coinfection.
• To explore bone health in HIV-infected children and adolescents.
• To discuss bone health in the context of pre-exposure prophylaxis (PrEP) and new ART management strategies.

Main Methods:

• Literature review of recent studies on HIV, bone health, and antiretroviral treatments.
• Synthesis of data on bone complications across different HIV-affected populations.
• Analysis of current and emerging strategies for bone protection in HIV management.

Main Results:

• HIV and certain antiretrovirals are associated with higher osteoporosis and fracture risks.
• Emerging data highlights bone complications in HIV/HCV coinfection and in pediatric/adolescent populations.
• Pre-exposure prophylaxis (PrEP) also requires consideration for bone health impacts.

Conclusions:

• Comprehensive risk assessment for osteoporosis and fractures is crucial in HIV-infected individuals.
• New management strategies are needed to mitigate ART's adverse effects on bone.
• Further research is warranted on bone health across the HIV spectrum, including youth and PrEP users.