Human immunodeficiency virus and osteoporosis

With the availability of effective antiretroviral therapy (ART), human immunodeficiency virus (HIV) has become a chronic disease and noninfectious comorbidities, such as osteoporosis, have become the major source of morbidity and mortality among people living with HIV (PLWH). Current evidence indicates that the risk of osteoporosis and fragility fracture is higher in PLWH compared to demographically matched HIV-uninfected persons, which is due to a complicated interaction between HIV disease-related factors (e.g., inflammation/immune activation), ART factors, and traditional risk factors. As a result, Dual-energy x-ray absorptiometry (DXA) screening is recommended in postmenopausal women with HIV and men with HIV age 50 years or older, particularly in those with additional risk factors. Until more data become available, treatment guidelines should follow those established for the general population.