Bone disease in HIV infection: a practical review and recommendations for HIV care providers.
Bone disease in HIV infection: a practical review and recommendations for HIV care providers.
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DOI：
10.1086/656412
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发表时间：
2010-10-15
期刊：
影响因子：
--
通讯作者：
Brown TT
中科院分区：
文献类型：
--
作者：
McComsey GA;Tebas P;Shane E;Yin MT;Overton ET;Huang JS;Aldrovandi GM;Cardoso SW;Santana JL;Brown TT
低骨矿物质密度（BMD）在人类免疫缺陷病毒（HIV）感染的受试者中普遍存在。开始抗逆转录病毒治疗与前2年BMD下降2%-6%相关，这一下降幅度与绝经前2年的持续下降幅度相似。最近的研究还表明，艾滋病毒感染者的骨折率增加。HIV感染者低BMD的原因似乎是多因素的，可能代表了HIV感染、传统骨质疏松症危险因素和抗逆转录病毒相关因素之间复杂的相互作用。在这篇综述中，我们提出了一个观点，即艾滋病毒感染应被视为骨疾病的危险因素。我们建议筛查脆性骨折患者、所有HIV感染的绝经后女性和所有≥50岁的HIV感染男性。我们还讨论了考虑骨质疏松症的次要原因的重要性。最后，我们讨论了更严重的骨骼疾病病例的治疗，同时概述了我们知识中的警告和差距。
Low bone mineral density (BMD) is prevalent in human immunodeficiency virus (HIV)–infected subjects. Initiation of antiretroviral therapy is associated with a 2%–6% decrease in BMD over the first 2 years, a decrease that is similar in magnitude to that sustained during the first 2 years of menopause. Recent studies have also described increased fracture rates in the HIV-infected population. The causes of low 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. In this review, we make the point that HIV infection should be considered as a risk factor for bone disease. We recommend screening patients with fragility fractures, all HIV-infected post-menopausal women, and all HIV-infected men ≥50 years of age. We also discuss the importance of considering secondary causes of osteoporosis. Finally, we discuss treatment of the more severe cases of bone disease, while outlining the caveats and gaps in our knowledge.
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