Osteopenia, Osteoporosis, and Fractures in HIV-Infected Patients: Extent of the Problem

In HIV-infected persons, osteoporosis is common and has a multifactorial etiology including traditional risk factors, such as smoking and low body weight, as well as direct effects of HIV infection and antiretroviral therapy. Multiple studies indicate that HIV-infected persons are at increased risk of low bone mass as compared to the general population. Emerging data suggest that the increased prevalence of reduced bone mass in HIV infection predisposes patients to an increased risk of fracture. This review discusses the epidemiology of low bone mass and fracture in HIV-infected persons, addresses the multiple causes of reduced bone mineral density in HIV infection, and offers recommendations on screening HIV-infected persons for bone loss.