HIV and bone disease

Bone Metabolism and HIV Infection

“…As well as establishing the contribution of known OP risk factors within the HIV-positive population, cross-sectional and longitudinal studies have also related changes in BMD to HIV-specific factors, for example duration of HIV infection, HIV viral load and CD4 cell count, to determine whether these represent independent risk factors for reduced BMD in the HIV-positive population and consequently whether HIV infection is a risk factor for reduced BMD in its own right. The extent of the rise in CD4 cell count was directly proportional to the BMD increase at the lumbar spine in one longitudinal study of patients on HAART (31). Similar findings were seen in another longitudinal study, although without adjustment for simultaneous rise in BMI (28).…”

Taming HIV-Related Inflammation with Physical Activity: A Matter of Timing

“…Poudel- Tandukar 30,31 Taken together, these data suggest that in HIV-infected individuals, this cardiovascular, metabolic, bone, and kidney damage is directly linked to the proinflammatory status induced by hypovitaminosis D as well as HIV-associated chronic inflammation, the direct effects of virus replication on osteoblast and osteoclast functions, and the effect of ART on bone turnover and kidney function. 32,33 In addition to metabolic, cardiovascular, bone, and kidney diseases, other non-AIDS-defining illnesses may be related to specific aspects of the complex immune dysfunction occurring in HIV-infected individuals. An interesting area filled with many open questions is how neurological disorders, and in particular the so-called HIV-associated neurocognitive disorders (HAND), result from the interaction among HIV, ART, and chronic immune activation.…”

An increased risk of osteoporosis in a HIV-infected patient in the era of HAART. Case report analysis

“…In patients with established bone insufficiency, bisphosphonate therapy should be considered. Alendronate in combination with vitamin D and calcium supplementation has been found effective in improving BDM values but larger studies of longer duration are needed [5,8] Preventive measures are not instigated prior to initiation of medication and even after onset of bone damage, therapeutic strategies are poorly implemented [46]. Never preventive measures in the form of physical activities and an appropriate diet during the first three decades should be omitted in order to create maximum bone mass formation.…”

“…The prevalence of reduced BMD and possibly also fracture incidence are increased in HIVpositive individuals compared with HIV-negative controls [5].…”