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Osteoporosis is a topic covered in the Johns Hopkins HIV Guide.

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  • Osteoporosis in HIV+ pts 3-4x more common than in general population.
  • Increased prevalence may be due in part to high prevalence of risk factors, including low body weight, hypogonadism, smoking, alcohol use, steroid use.
  • Role of ART unclear. ART initiation associated with 2-3% loss in bone mineral density (BMD) in first 6 mos in multiple studies. Unclear if due to medication effect or by-product of viral suppression and/or immune reconstitution. Longitudinal studies of treated HIV+ pts generally show stable BMD over time.
  • Specific ARVs not clearly implicated in pathogenesis, although bone loss with TDF slightly more pronounced than with d4T.
  • BMD explains approximately 50% of fracture risk in general population,perhaps less in HIV+ pts. Bone quality also important but difficult to assess.
  • Fracture risk in HIV+ pts not adequately assessed to date

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Last updated: February 2, 2011


Brown, Todd T. "Osteoporosis." Johns Hopkins HIV Guide, 2011. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545154/3/Osteoporosis.
Brown TT. Osteoporosis. Johns Hopkins HIV Guide. 2011. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545154/3/Osteoporosis. Accessed August 19, 2019.
Brown, T. T. (2011). Osteoporosis. In Johns Hopkins HIV Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545154/3/Osteoporosis
Brown TT. Osteoporosis [Internet]. In: Johns Hopkins HIV Guide. ; 2011. [cited 2019 August 19]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545154/3/Osteoporosis.
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