HIV and bone metabolism

Reduced bone density and abnormal bone turnover has recently been reported in HIV-infected patients receiving antiretroviral therapy. In addition, rec ent data suggest that individuals infected with HIV are at an increased ris k for avascular necrosis. A number of factors, including potential medicati on toxicity, undernutrition, hypogonadism, abnormalities in calcium homeost asis, or HIV infection itself, may be contributing to the bone pathology in this population. However, the specific mechanisms of the disordered bone t urnover and reduced bone density in HIV-infected patients have not yet been identified. Moreover, the associated vertebral fracture risk of this newly identified osteopenia in the HIV-infected population has yet to be fully a ssessed. This paper reviews the literature to date on bone metabolism in HI V-infected patients, highlighting possible etiologies and contributors to t he observed reduction in bone density in this population.