Greater Bone Loss in Post-Menopausal Women with HIV

By: Bibin Thomas, Long Island University, PharmD Candidate

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Earlier in 2011, it was reported that that young and middle-aged HIV positive patients did not need to receive routine Bone Mineral Density (BMD) tests.  BMD helps to identify patients who are at a high risk for bone fractures or weakened bone structures (and eventually need therapy to prevent fractures).  Previous studies indicated that people on highly active antiretroviral therapy (HAART) “would see increasing BMD as they regain weight.”  This meant that there was at least one less adverse effect to worry about for patients with HIV or AIDS.

Alas, new studies conducted with HIV positive and HIV negative post-menopausal women indicate that the post-menopausal women with HIV may now have to concern themselves about their bones.  Despite data from previous trials, patients taking antiretroviral medications may develop osteoporosis or bone fractures.  To make matters worse, the bone loss may be greater than previously thought.  Researchers say that the best way to address this issue is by utilizing dual-energy x-ray absorptiometry to analyze the BMD and assessing the patient for other treatable risk factors for osteoporosis.

Life is already difficult for HIV/AIDS patients, but the more we learn about bone loss and the earlier we identify high-risk patients the sooner we can begin treatment to prevent bone fracture or osteoporosis.  As healthcare professionals, we can go above-and-beyond our duties to make their lives a little bit easier and healthier.

SOURCES:

1. Yin MT, Zhang CA, McMahon DJ, et. al. Higher Rates of Bone Loss in Postmenopausal HIV-Infected Women: A Longitudinal Study. J Clin Endocrinol Metab. 2011 Nov 16.
2. Bolland MJ, Wang TK, Grey A, et. al. Stable bone density in HAART-treated individuals with HIV: a meta-analysis. J Clin Endocrinol Metab. 2011 Sep;96(9):2721-31.