HIV infection and antiretroviral therapy have long been associated with an increased risk of osteopenia and osteoporosis. This predisposition has now been shown to result in a significantly increased risk of osteoporotic fractures in the HIV-infected population even after controlling for known risk factors.
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References
Tebas, P. et al. Accelerated bone mineral loss in HIV-infected patients receiving potent antiretroviral therapy. AIDS 14, F63–F67 (2000).
Serrano, S. et al. Bone remodelling in human immunodeficiency virus-1-infected patients. A histomorphometric study. Bone 16, 185–191 (1995).
Güerri-Fernandez, R. et al. HIV infection is strongly associated with hip fracture risk, independently of age, gender and co-morbidities: A population-based cohort study. J. Bone Miner. Res. http://dx.doi.org/10.1002/jbmr.1874.
Triant, V. A., Brown, T. T., Lee, H. & Grinspoon, S. K. Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large U. S. healthcare system. J. Clin. Endocrinol. Metab. 93, 3499–3504 (2008).
Bedimo, R., Maalouf, N. M., Zhang, S., Drechsler, H. & Tebas, P. Osteoporotic fracture risk associated with cumulative exposure to tenofovir and other antiretroviral agents. AIDS 26, 825–831 (2012).
McComsey, G. A. et al. Bone mineral density and fractures in antiretroviral-naive persons randomized to receive abacavir-lamivudine or tenofovir disoproxil fumarate-emtricitabine along with efavirenz or atazanavir-ritonavir: Aids Clinical Trials Group A5224s, a substudy of ACTG A5202. J. Infect. Dis. 203, 1791–1801 (2011).
Hoy, J. et al. Interruption or deferral of antiretroviral therapy reduces markers of bone turnover compared with continuous therapy: The SMART Body Composition substudy. J. Bone Miner. Res. http://dx.doi.org/10.1002/jbmr.1861.
Gallant, J. E. et al. Efficacy and safety of tenofovir DF vs stavudine in combination therapy in antiretroviral-naive patients: a 3-year randomized trial. JAMA 292, 191–201 (2004).
National Osteoporosis Foundation. Clinician's guide to prevention and treatment of osteoporosis (Washington, DC, National Osteoporosis Foundation, 2010).
McComsey, G. A. et al. Bone disease in HIV infection: a practical review and recommendations for HIV care providers. Clin. Infect. Dis. 51, 937–946 (2010).
Acknowledgements
R. Bedimo is supported by VA MERIT grant I01 CX000418-01A1. P. Tebas is supported by grant AI045008.
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Bedimo, R., Tebas, P. Increased fracture risk with HIV infection—a growing concern. Nat Rev Endocrinol 9, 260–261 (2013). https://doi.org/10.1038/nrendo.2013.62
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DOI: https://doi.org/10.1038/nrendo.2013.62