Protecting bone in long-term HIV positive patients receiving antiretrovirals

Expert Rev Anti Infect Ther. 2016 Jun;14(6):587-99. doi: 10.1080/14787210.2016.1184570.


Introduction: As the population of people living with HIV ages, the increase in non-AIDs morbidities is expected to increase in parallel. Maintaining bone health in those with HIV will be an important area of focus for the HIV clinician to prevent the morbidity and mortality associated with fragility fractures, the principal clinical sequela of low bone mineral density (BMD). Rates of fractures and prevalence of low bone mineral density, a risk factor for future fragility fractures, are already increased in the HIV positive population.

Areas covered: This review examines the strategies to maintain bone health in those living with HIV from screening through to managing those with established low BMD or fracture, including the role for choice of or modification of antiretroviral therapy to maintain bone health. Expert commentary: The increasing complexity of managing bone health in the age of succesful antiretroviral therapy and an aging patient population as well as future perspectives which may help achieve the long term aim of minimising the impact of low BMD in those with HIV are discussed and explored.

Keywords: Bone; HIV; antiretroviral therapy; bisphosphonates; bone mineral density; fractures in HIV; osteoporosis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Anti-Retroviral Agents / administration & dosage
  • Anti-Retroviral Agents / adverse effects
  • Anti-Retroviral Agents / therapeutic use*
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / therapeutic use
  • Bone Density* / drug effects
  • Cholecalciferol / administration & dosage
  • Cholecalciferol / therapeutic use
  • Ergocalciferols / administration & dosage
  • Ergocalciferols / therapeutic use
  • Fractures, Bone / complications
  • Fractures, Bone / epidemiology
  • Fractures, Bone / prevention & control*
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • Humans
  • Osteoporosis / complications
  • Osteoporosis / epidemiology
  • Osteoporosis / prevention & control*
  • Risk Factors


  • Anti-Retroviral Agents
  • Bone Density Conservation Agents
  • Ergocalciferols
  • Cholecalciferol