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

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

M J Kruger  1 , T A Nell  2
Affiliations
Review

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

M J Kruger et al. AIDS Res Ther. .

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.

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Figures

Fig. 1
Fig. 1
Representative data indicating (a) the lifetime risk of fractures, (b) the incidence of fractures and (c) the incidence of low bone mass and osteoporosis
Fig. 2
Fig. 2
The general pattern of bone development and loss over time. During years 0–20, bone starts to grow, during the ages of 20–30 years, modelling takes place and peak bone growth is reached. This is followed by the remodelling phase where bone loss is evident
Fig. 3
Fig. 3
The restoration of suboptimal calcium levels
See this image and copyright information in PMC

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