HIV, bone loss and early HIV treatment

A low CD4 cell count before starting HIV treatment is associated with an increased risk of bone loss during the early years of antiretroviral therapy, new research shows. HIV Weekly. 21 August 2013.

Infection with HIV is associated with low bone mineral density (BMD) and there is some evidence of an increased risk of fragility fractures. BMD continues to fall after HIV treatment is started. The reasons for this are uncertain. However, it has been suggested that immune restoration could be a cause.

Researchers in the US monitored BMD in approximately 800 people who started HIV treatment between 1998 and 2007.

BMD was checked using DEXA scans before starting HIV treatment and then 96 weeks after starting treatment.

BMD declined by an average of 2% during the course of the study.

However, people with a baseline CD4 cell count below 50 cells/mm3 lost 3% more BMD than people with a pre-treatment CD4 cell count above 500 cells/mm3.

Other risk factors for bone loss included being female, and having a lower body mass index (BMI) and higher viral load.

The researchers believe their research underlines the importance of starting HIV treatment promptly.

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