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Related Experiment Videos

Bone Loss in HIV Infection.

Caitlin A Moran1,2, M Neale Weitzmann3,4, Ighovwerha Ofotokun1,2

  • 1Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine.

Current Treatment Options in Infectious Diseases
|April 18, 2017
PubMed
Summary

Human immunodeficiency virus (HIV) infection and its treatment with combination antiretroviral therapy (cART) contribute to bone loss. Newer therapies and supplements may mitigate this risk, but further research is needed for optimal bone health strategies.

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Area of Science:

  • Bone Metabolism
  • Virology
  • Pharmacology

Background:

  • Human immunodeficiency virus (HIV) infection is a known risk factor for reduced bone mineral density (BMD) and increased fracture risk.
  • Combination antiretroviral therapy (cART) used to treat HIV can exacerbate bone loss, especially within the initial years of treatment.
  • The aging HIV-positive population on cART is projected to experience a higher incidence of low BMD and fragility fractures.

Purpose of the Study:

  • To review the mechanisms contributing to bone loss in HIV-infected individuals.
  • To evaluate the impact of various cART regimens and potential mitigating strategies on bone health.
  • To identify future research needs for managing fragility bone disease in the HIV population.

Main Methods:

  • Literature review of studies investigating bone mineral density (BMD) in HIV-infected individuals.
Keywords:
HIVbisphosphonatescombination antiretroviral therapyimmune reconstitutionosteopeniaosteoporosis

Related Experiment Videos

  • Analysis of the effects of different antiretroviral drugs, including tenofovir disoproxil fumarate (TDF), protease inhibitors (PIs), integrase strand transfer inhibitors, and tenofovir alafenamide (TAF).
  • Examination of emerging data on preventive measures such as bisphosphonates and vitamin D/calcium supplementation.

    • Main Results:

    • HIV infection and cART, particularly TDF and PIs, are associated with significant bone loss.
    • Prophylaxis with bisphosphonates or vitamin D and calcium may reduce cART-associated BMD loss.
    • Newer agents like TAF and integrase inhibitors appear to cause less bone loss compared to older regimens.

    Conclusions:

    • Bone loss is a significant concern in the aging HIV-positive population due to infection and cART.
    • Early intervention with specific antiretroviral choices and supplementation shows promise in preserving bone health.
    • Further research is essential to define optimal bone-sparing cART strategies, screening protocols, and preventive measures.