As a number of recent news reports have highlighted, osteoporosis can be a health concern for people with HIV, so we’d like to draw your attention to the information sheet presented on the website aidsmap.com, which is sponsored by the leading HIV health information nonprofit in Britain.
Below are some excerpts from the online information sheet:
Why does osteoporosis occur in people with HIV?
Osteoporosis is caused by a lack of bone calcium and protein, but the reasons for its appearance in relatively young, HIV-positive people, is still unexplained.
The high prevalence of osteopenia in HIV-positive people relative to HIV-negative people suggests that HIV itself contributes to thinning bones in this population (Knobel 2001; McGown 2001; Negredo 2001). However, it is not yet clear whether other factors contribute to thinning bones in HIV-positive people. There is growing evidence that protease inhibitors are not associated with osteoporosis but other antiretrovirals may contribute to this condition.
Link to protease inhibitors and metabolic disorders?
Several studies have found that protease inhibitor (PI) treatment has been associated with a significantly greater incidence of osteoporosis.
For example, one study found that 21% of a group of 64 men receiving PIs, compared with 6% of an age-matched HIV-negative control group, had severe osteoporosis. There was no significant relationship between osteoporosis and fat redistribution (Tebas 2000). Fifty percent of the PI group had some evidence of reduced bone mass, compared to 29% of the control group. Although some researchers have speculated that reduced level of the male sex hormone testosterone might be linked to reduced bone mass, no link was found in this study.
Treatment of osteoporosis
In a recent presentation, one of the leading researchers on osteoporosis in HIV suggested that the only interventions currently supported by evidence are to ensure an adequate calcium intake (approximately 1500mg per day), and to ensure a vitamin D intake of between 400 and 1000IU per day.
You can read the complete aidsmap.com information sheet on osteoporosis in people with HIV at: