title: Do people with HIV infection have a higher risk of fracture compared with those without HIV infection?
abstract: OBJECTIVE
  This review details recent findings that inform the prevalence and incidence of fractures in people living with HIV (PLWH) and examines the effects of HIV infection and antiretroviral therapy (ART), as well as demographics and traditional risk factors on fractures. As antiretroviral guidelines have recently changed to recommend the introduction of ART at diagnosis of HIV infection, the long-term effects of ART on bone health and fracture risk need to be better understood.
  
  
  RESULTS
  It is apparent that both the effects of HIV infection alone and initiation of ART are associated with significant bone loss in individuals with HIV infection, resulting in osteopenia and osteoporosis. The clinical consequence of low bone mineral density is a greater risk of fragility fractures that are more common in older HIV patients, and those on ART. Frailty occurs at a prevalence of about 10% (about twice that of the general population), and the increased propensity of falls results in greater fracture prevalence, morbidity and mortality.
  
  
  CONCLUSIONS
  This review examines data from recent cohort studies and clinical trials to inform a better understanding of the complex relationship between the effects of HIV infection, ART and demographics on fractures in PLWH.
authors.affiliation: aDepartment of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia bInternational Association of Providers of AIDS Care, Washington, District of Columbia, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hoy
authors.forename: Benjamin
authors.initials: B
authors.lastname: Young
mesh_terms: D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001851:Bone Diseases, Metabolic / Q000139:chemically induced* / Q000150:complications*; D001842:Bone and Bones / Q000187:drug effects*; D050723:Fractures, Bone / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D018570:Risk Assessment
chemical_list: D044966:Anti-Retroviral Agents