Bone abnormalities in HIV-infected patients on HAART

Recently, a high incidence of osteopenia and osteoporosis has been observed in HIV-infected individuals. This problem seems to be more frequent in patients receiving potent antiretroviral therapy, although a specific contribution (if any) of the drugs used in combination regimens has yet to be established. There have also been several reports of other bone-related complications in HIV-infected individuals including avascular necrosis of the hip and compression fracture of the lumbar spine. People living with HIV have significant alterations in bone metabolism regardless of whether or not they are receiving potent antiretroviral therapy. The underlying mechanisms to account for these observations remain unknown, although studies are underway to examine the relationship between the bone abnormalities and other complications associated with HIV and antiretroviral therapy. HIV-infected patients with osteopenia or osteoporosis should be treated similarly to seronegative patients with appropriate use of nutritional supplements (Calcium and Vitamin D) and exercise. Hormone replacement and anti-resorptive therapies might be also indicated.