Bone disease in HIV infection.

The advent of highly active anti-retroviral therapy (HAART) has dramatically decreased the rate of AIDS-related mortality and significantly extended the life span of patients with AIDS.A variety of metabolic side effects are associated with these therapies, one of which is metabolic bone disease. The causes of low bone mineral density (BMD) in individuals with HIV infection appear to be multifactorial and likely represent a complex interaction between HIV infection, traditional osteoporosis risk factors, and antiretroviral related factors.This review summarizes the clinical evidence linking HIVassociated osteoporosis to direct infection and antiretroviral therapy use. The purported mechanisms involved in bone loss are also reviewed. Additionally, recommendations regarding the pharmacologic management of HIV/HAART-related osteoporosis are given. In conclusion, we make the point that HIV infection should be considered as a risk factor for bone disease.