Low Bone Density - New Study shows no correlation to HIV
Jan 3, 2013
Based on what I'm reading in this study on no correlation between low bone density and HIV, I am excited. Should I be excited? There's a study for everything these days.
Response from Dr. Young
Hi and thanks for posting.
There is a growing appreciation of how common bone problems are among populations of people living with HIV. I did an interview with the late, great Bonnie Goldman and Professor Todd Brown on this subject a couple of years ago that might serve as useful background. Our group at the HIV Outpatient Study (HOPS)/CDC published this report that showed that in the US, positives were at significantly greater risk to have bone fractures than the general population and that CD4 nadir count and hepatitis C infection were risk factors. Certain HIV medications have been associated with low bone density (including tenofovir and protease inhibitors). Other studies have shown that non-HIV factors, such as family history, smoking and vitamin D deficiency (among others) are contributory.
Bone problems are multifactorial- in any population of people different factors may contribute more than others.
The study that you mention was of relatively small size, concluded that among gay men in Amsterdam that low bone density was similarly prevalent, in both HIV+ and HIV- individuals. This isn't reason to be excited, it's a cause for concern- it says that life style factors (hopefully reversible ones) dominate the measurable risk for this population of people. Indeed, a similar conclusion was drawn from this study of HIV negative gay men in San Francisco that showed that 10% had abnormally low bone density.
Overall, I advise all of my patients to be aware of their bone health risks, speak to their care providers about testing for low bone density and steps that they can take to avoid osteoporosis and fractures in the future.
Hope that helps, BY
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