Pathogenesis of bone disorders in HIV infection. (April 2009)

• Record Type: Journal Article
• Authors: Venhoff, Nils; Walker, Ulrich Andreas
• Is Part Of: International journal of clinical rheumatology. Volume 4:Number 2(2009)
• Page Start: 147
• Page End: 159
• Publication Date: 2009-04
• Subjects: AIDS -- antiretroviral therapy -- bone disease -- HIV -- NRTI -- nucleoside analog reverse transcriptase inhibitor -- osteomalacia -- osteonecrosis -- osteopenia -- osteoporosis -- protease inhibitor; Rheumatology -- Periodicals; 616.723005
• DOI: 10.2217/ijr.09.10
• Languages: English
• ISSNs: 1758-4272

Abstract

Iatrogenic long-term complications of antiretroviral therapy have become a focus of intense research in patients with HIV infection. Antiretroviral therapy has almost normalized the survival of newly infected and drug-adherent individuals, but skeletal complications are of growing concern in the aging population. It has become clear that the prevalence of osteoporosis and related fractures in HIV-infected subjects has increased. Risk factors are multifactorial and include a low body mass index, smoking and possibly viral replication itself and antiretroviral treatment. Treatment with tenofovir in particular may induce osteomalacia in some patients. HIV infection is also complicated by osteonecrosis, which is approximately 100-fold more prevalent than in the general population. Biphosphonates represent the first-line therapy for osteoporosis in HIV-infected patients, but their effects on fractures have not yet been evaluated.