Bone changes and fracture risk in individuals infected with HIV.
The life expectancy of individuals infected with HIV has improved greatly since the institution of combination antiretroviral therapy. However, many metabolic derangements have been discovered with long-term combination antiretroviral treatment, including lipodystrophy; insulin resistance; and, more recently, abnormal bone metabolism. It is well-documented that bone mineral density (BMD) in HIV-positive patients is lower compared with the expected BMD in non-HIV-positive patients. The underlying cause of lower BMD is unknown but is thought to be a multifactorial process. Conflicting evidence exists regarding the effect of antiretroviral exposure and duration of treatment, antiretroviral type, and cumulative HIV viral exposure on bone health. Here we review the bone changes that occur with HIV infection and treatment.
Warriner
Amy H
AH
Division of Endocrinology, Metabolism, and Diabetes, University of Alabama at Birmingham, FOT 702, 2000 6th Avenue South, Birmingham, AL 35233-0271, USA. warriner@uab.edu
Mugavero
Michael J
MJ
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology* / Q000378:metabolism; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D050071:Bone Density Conservation Agents