title: Pharmacologic approaches to the prevention and management of low bone mineral density in HIV-infected patients.
abstract: OBJECTIVE
  Osteoporosis is a growing concern among people living with HIV (PLWH) because of the recognized risk of fractures, which bring with them morbidity and mortality. New evidence is helping clinicians understand how to prevent and manage osteoporosis in this subpopulation.
  
  
  RESULTS
  The benefit of calcium and vitamin D is variable in osteoporosis literature in general, but evidence supports the use of these supplements in PLWH to prevent the loss of bone mineral density when initiating antiretroviral therapy and in enhancing the effectiveness of antiosteoporosis treatments. Of the osteoporosis treatments, alendronate and zoledronate are the only two with substantial evidence of safety and effectiveness in PLWH, but the studies have been small and of limited duration. There are no randomized controlled studies of raloxifene, denosumab or teriparatide in PLWH. Of increasing interest is the possible benefit of statins on bone health through decreased inflammation.
  
  
  CONCLUSIONS
  Osteoporosis is recognized as an issue for PLWH. Although some of the available osteoporosis treatments have proven safe and effective, future studies of the novel treatments, such as statins, along with well-designed studies of established osteoporosis treatments for use in PLWH are needed to further guide the clinical management of osteoporosis in this population.
authors.affiliation: aFundació Lluita contra la SIDA, Hospital Germans Trias i Pujol; Universitat Autònoma de Barcelona; Universitat de Vic-Universitat Central de Catalunya, Barcelona, Spain bUniversity of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Negredo
authors.forename: Amy H
authors.initials: AH
authors.lastname: Warriner
mesh_terms: D019386:Alendronate / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D010024:Osteoporosis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D000077211:Zoledronic Acid
chemical_list: D000893:Anti-Inflammatory Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D019386:Alendronate