HIV-1 infection and antiretroviral therapies: risk factors for osteoporosis and bone fracture

• Type of Material: Article
• Authors: Igho Ofotokun, Emory University; M Neale Weitzmann, Emory University
• Language: English
• Date: 2010-12
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010 Wolters Kluwer Health; Lippincott Williams & Wilkins
• Final Published Version (URL): http://journals.lww.com/co-endocrinology/pages/articleviewer.aspx?year=2010&issue=12000&article=00006&type=abstract
• Title of Journal or Parent Work: Current Opinion in Endocrinology, Diabetes and Obesity
• ISSN: 1752-296X
• Volume: 17
• Issue: 6
• Start Page: 523
• End Page: 529
• Grant/Funding Information: The authors gratefully acknowledge financial support from NIAMS (AR059364) to M.N.W. and I.O., and AR053607 to M.N.W. M.N.W. is also supported in part by NIAMS grant AR056090 and by a grant from the Biomedical Laboratory Research & Development Service of the VA Office of Research and Development (5I01BX000105). I.O. is also supported in part by K23 A1073119 from NIAID.
• Keywords: OPG; osteoclast; AIDS; RANKL; osteoporosis; HIV
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Pathology

Abstract

Purpose of review Patients with HIV-1 infection/AIDS are living longer due to the success of highly active antiretroviral therapy (HAART). However, serious metabolic complications including bone loss and fractures are becoming common. Understanding the root causes of bone loss and its potential implications for aging AIDS patients will be critical to the design of effective interventions to stem a tidal wave of fractures in a population chronically exposed to HAART. Recent findings Paradoxically, bone loss may occur not only due to HIV/AIDS but also as a consequence of HAART. The cause and mechanisms driving these distinct forms of bone loss, however, are complex and controversial. This review examines our current understanding of the underlying causes of HIV-1 and HAART-associated bone loss, and recent findings pertaining to the relevance of the immuno-skeletal interface in this process. Summary It is projected that by 2015 more than half of the HIV/AIDS population in the USA will be over the age of 50 and the synergy between HIV and/or HAART-related bone loss with age-associated bone loss could lead to a significant health threat. Aggressive antiresorptive therapy may be warranted in high-risk patients.