HIV/AIDS and bone: an unrecognised threat?

Abstract

Since the first isolated cases of acquired immunodeficiency syndrome (AIDS) was described in homosexual men in the United States in 1981, the Human Immunodeficiency Virus (HIV) infection has spread globally affecting 33 million people. With the advent of highly active antiretroviral therapy (HAART) there has been a paradigm shift in the clinical profile of patients with HIV. Prior to effective HAART, patients usually had a progressive fatal course characterised by recurrent opportunistic infections. Since the introduction of HAART, which has dramatically improved these patients survival, conditions associated with accelerated aging, have come to the fore, especially cardiovascular disease, malignancy, diabetes mellitus and metabolic bone disease. The aim of this review is to increase the knowledge of HIV associated metabolic bone disease, alert health care providers of the possible bone complications associated with HIV and HAART and stimulate further research in the field.