Purpose of review Osteoporosis
is a growing concern among people living with HIV
(PLWH) because of the recognized risk of fractures, which bring with them morbidity and mortality. New evidence is helping clinicians understand how to prevent and manage osteoporosis
in this subpopulation.
The benefit of calcium and vitamin D is variable in osteoporosis
literature in general, but evidence supports the use of these supplements in PLWH to prevent the loss of bone mineral density when initiating antiretroviral therapy and in enhancing the effectiveness of antiosteoporosis treatments. Of the osteoporosis
treatments, alendronate and zoledronate are the only two with substantial evidence of safety and effectiveness in PLWH, but the studies have been small and of limited duration. There are no randomized controlled studies of raloxifene, denosumab or teriparatide in PLWH. Of increasing interest is the possible benefit of statins
on bone health through decreased inflammation.
is recognized as an issue for PLWH. Although some of the available osteoporosis
treatments have proven safe and effective, future studies of the novel treatments, such as statins
, along with well-designed studies of established osteoporosis
treatments for use in PLWH are needed to further guide the clinical management of osteoporosis
in this population.