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Bone Loss and Antiretroviral Therapy in HIV and HCV

Infectious Disease Advisor reports several studies have observed an increased prevalence of osteopenia and osteoporosis in people living with HIV (PLWH). Reduced bone mineral density (BMD) and fracture risk in this population have been linked to HIV infection and treatment, indicating antiretroviral therapy (ART) as a key contributing factor.

Infectious Disease Advisor spoke to experts who discussed the effects of ART on bone health in PLWH, including Jessica Rachel Starr, MD, endocrinologist at HSS. Dr. Starr explained, “ART, when given intermittently vs continuously, has a better effect on BMD decline, meaning bone density is less negatively affected when patients take breaks from the antiretroviral agents.” She added, “This is a complex topic and highlights how HIV has become a chronic disease, meaning patients with HIV are living long enough to develop chronic age-related conditions such as osteoporosis, although they are perhaps developing these conditions at an earlier time in life and with a higher degree of severity than their HIV-negative peers.”

Dr. Starr expressed the need for further research, stating, “Additional research is needed to tease out the relative contribution of the HIV itself to low BMD vs the medications used to control the virus. There is also a need to determine whether ART affects bone metabolism or vitamin D metabolism or both.”

Dr. Starr also addressed key considerations for clinicians, citing, “Osteoporosis and osteopenia are more common in women, older patients, and those with lower body weight. All patients with HIV should have BMD screening before initiating treatment with ART.”

Read the full article at Infectiousdiseaseadvisor.com.