艾滋病毒感染者的骨健康:从病理生理学到实际管理
1Division of Infectious Diseases, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. eunjeong.joo@samsung.com.
Infection & chemotherapy
|March 9, 2026
概括
艾滋病毒感染者 (PLWH) 面临因衰老和抗逆转录病毒治疗 (ART) 的骨质损失增加. 优化ART和监测骨健康对于管理骨质疏松症和骨折在这个人群中至关重要.
科学领域:
- 骨代谢和艾滋病毒/艾滋病研究
- 药理学和药物安全问题
- 老年医学和公共卫生.
背景情况:
- 抗逆转录病毒疗法 (ART) 增加了艾滋病毒感染者 (PLWH) 的预期寿命.
- 与普通人群相比,PLWH的骨质损失,骨矿物质密度 (BMD) 降低和骨折率更高.
- 导致骨质损失的因素包括慢性免疫激活,炎症和与ART相关的毒性.
研究的目的:
- 审查ART对老化PLWH骨健康的影响.
- 讨论有关骨安全的当前和新兴ART疗法.
- 概述PLWH骨病的基本评估和管理策略.
主要方法:
- 关于艾滋病毒,ART和骨健康研究的文献综述.
- 对特定ART药物毒性数据的分析 (例如,特诺福维尔二氧化烟酸,特诺福维尔阿拉芬胺).
- 对较新的疗法和骨健康结果的证据评估.
主要成果:
- 某些ART,如诺福维尔二松胺,与降低的BMD和低血症有关.
- 较新的治疗方案,包括基于整合酶抑制剂或诺福维尔节约的选择,显示了骨安全概况的改善.
- 无论 ART 治疗方案如何,骨损失都可能发生,这凸显了长期监测的必要性.
结论:
- 骨健康是衰老PLWH的一个关键的长期并发症.
- 双能X射线吸收度和骨折风险评估工具对于早期检测至关重要.
- 综合护理需要整合骨健康管理,包括生活方式,补充剂和药物治疗,以及优化ART选择.
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