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

• Published in: AIDS research and therapy Vol. 14; no. 1; p. 35
• Main Authors: Kruger, M J, Nell, T A
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26.07.2017; BioMed Central; BMC
• Subjects: Absorptiometry, Photon; Acquired immune deficiency syndrome; Age; AIDS; AIDS/HIV; Antiretroviral agents; Antiretroviral Therapy, Highly Active; Body composition; Body Composition - physiology; Bone and Bones - physiopathology; Bone density; Bone Density - physiology; Bone mineral density; Bones; Density; DEXA; Drug therapy; Dual energy X-ray absorptiometry; Equipment costs; Female; Fractures; Health aspects; Highly active antiretroviral therapy; HIV; HIV (Viruses); HIV Infections - drug therapy; HIV Infections - physiopathology; Human immunodeficiency virus; Humans; Incidence; Literature reviews; Magnetic Resonance Imaging; Male; Mens health; Middle Aged; Osteoporosis; Prognosis; Public health; QUS; Review; Risk analysis; Risk Factors; Screening; Social behavior; South Africa; Teenagers; Tomography, X-Ray Computed; Ultrasonic waves; Ultrasonography - methods; Ultrasound; Urbanization; Viruses; Womens health; South Africa; United States > US; Bone mineral density; HIV; DEXA; Body composition; QUS
• ISSN: 1742-6405; 1742-6405
• DOI: 10.1186/s12981-017-0162-y

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.