Abstract and readers response- The treatment of HIV-1 patients with antiretroviral therapy has led to a significant reduction in the mortality and mobility. However, these antiretroviral therapies have been linked with side effects like insulin resistance and reduction in bone mineral density (BMD), leading to osteopenia and osteoporosis. Osteopenia and osteoporosis are very common in HIV- infected patients and represent challenges in clinical and therapeutic management. The mechanisms behind this degenerative process are largely unsettled. It has not yet been determined whether these bone dysfunctions are directly associated with the antiretroviral therapies like highly active antiretroviral therapy (HAART) or not. There are some evidences that show that the virulence and pathogenicity of HIV itself is an independent risk factor. On the other hand, some studies show that HAART has adverse skeletal effects. Some of the meta-analysis studies published from 2002 to 2011 showed osteoporosis in 15% HIV patients and osteopenia in 52% HIV patients receiving HAART, but longitudinal studies found no evidence that HAART contributed osteopenia and osteoporosis. This review analyses an array of mechanisms that could account for rapid bone degeneration among the HIV-infected patients. The review will also address the preventative and therapeutic strategies with bone specific treatments like bisphosphates in conjunction with vitamin D and calcium supplements. But again, this is a new emerging topic and more studies with large sample size and longer duration are needed. WC-231
Reader’s profile- I imagine readers who deal with the HIV- infected patients such as physicians, and have little information about the mechanisms and side effects of HAART.
Reader’s response- I thought HAART is a miracle treatment for HIV infected patients. I knew that lower t-cell counts in HIV infected patients make them vulnerable to bone loss. I had no idea HAART can also cause bone dysfunction. Now, I know the whole mechanism of how HIV as well as HAART can lead to bone loss. Interesting though, I can minimize further bone loss in my patients by monitoring their BMD and prescribing bisphosphate. Hmmm this review says further studies are needed to test the association of HAART and osteoporosis which means I need to keep up with the recent studies about HAART and osteoporosis.
The treatment of HIV-1 patients with antiretroviral therapy has led to a significant reduction in the mortality and mobility. However, these antiretroviral therapies have been linked with side effects like insulin resistance and reduction in bone mineral density (BMD), leading to osteopenia and osteoporosis. Osteopenia and osteoporosis are very common in HIV- infected patients and represent challenges in clinical and therapeutic management. The mechanisms behind this degenerative process are largely unsettled. It has not yet been determined whether these bone dysfunctions are directly associated with the antiretroviral therapies like highly active antiretroviral therapy (HAART) or not. There are some evidences that show that the virulence and pathogenicity of HIV itself is an independent risk factor. On the other hand, some studies show that HAART has adverse skeletal effects. Some of the meta-analysis studies published from 2002 to 2011 showed osteoporosis in 15% HIV patients and osteopenia in 52% HIV patients receiving HAART, but longitudinal studies found no evidence that HAART contributed osteopenia and osteoporosis. This review analyses an array of mechanisms that could account for rapid bone degeneration among the HIV-infected patients. The review will also address the preventative and therapeutic strategies with bone specific treatments like bisphosphates in conjunction with vitamin D and calcium supplements. But again, this is a new emerging topic and more studies with large sample size and longer duration are needed.
WC-231
Reader’s profile-
I imagine readers who deal with the HIV- infected patients such as physicians, and have little information about the mechanisms and side effects of HAART.
Reader’s response-
I thought HAART is a miracle treatment for HIV infected patients. I knew that lower t-cell counts in HIV infected patients make them vulnerable to bone loss. I had no idea HAART can also cause bone dysfunction. Now, I know the whole mechanism of how HIV as well as HAART can lead to bone loss. Interesting though, I can minimize further bone loss in my patients by monitoring their BMD and prescribing bisphosphate. Hmmm this review says further studies are needed to test the association of HAART and osteoporosis which means I need to keep up with the recent studies about HAART and osteoporosis.