I am a long term survivor who was recently diagnoised with Osteoperosis, I am having trouble with memory, fatigue. It seems strange to survive for 25 years only to have these things happen. What is the best course of action? I broke my right foot last year and was subsequently diagnoised with Osteonecrosis.

You should discuss with your HIV specialist what risks factors you have for bone loss (osteoporosis) that might need attention (use of corticosteroids, smoking, low hormone levels, lack of exercise). Getting a DEXA bone scan can determine the extent of bone loss. For many patients, aggressive vitamin D supplementation, calcium supplements, and possibly use of a biphosphonate sucn as alendronate may stabilize or even reverse thinning bones as well as addressing the other risk factors. Treatment of HIV may have a variable effect on bone health that is still being worked out (study results have been somewhat mixed). A small % of patients on tenofovir may develop significant bone problems necessitating switch to an alternative drugs. For the concenr about memory loss I would discuss with yor HIV provider whether to request a neuropsych evaluation to determine the status of your cognitive (brain) function. KH