Bone mineral density in people living with HIV: a narrative review of the literature

AIDS Res Ther. 2017 Jul 26;14(1):35. doi: 10.1186/s12981-017-0162-y.

Abstract

Bone health status is largely absent in South Africa, the main reasons being the absence and cost-effectiveness of specific screening equipment for assessing bone mineral density (BMD). Various risk factors seem to play a role, some of which can be modified to change bone health status. Urbanisation is also a public health concern. Changing nutritional, as well as social behaviour, play integral roles in the prevalence and incidence of decreased BMD. Furthermore, human immunodeficiency virus (HIV) specifically, has a negative impact on BMD and although highly active antiretroviral therapy increases the prognosis for HIV-infected individuals, BMD still seem to decrease further. Dual energy X-ray absorptiometry is considered the gold standard for BMD assessment; however, recent developments have provided more cost-effective screening methods, among which heel quantitative ultrasound appears to be the most widely used in resource limited countries such as South Africa.

Keywords: Body composition; Bone mineral density; DEXA; HIV; QUS.

Publication types

  • Review

MeSH terms

  • Absorptiometry, Photon
  • Antiretroviral Therapy, Highly Active
  • Body Composition / physiology
  • Bone Density / physiology*
  • Bone and Bones / physiopathology*
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / physiopathology*
  • Humans
  • Incidence
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Risk Factors
  • South Africa
  • Tomography, X-Ray Computed
  • Ultrasonography / methods