Women HIVers' Bone Problems

According to a study to be published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism, postmenopausal HIV-infected women have a high prevalence of low-bone-mineral density and high bone turnover placing them at high risk for future bone fractures.

[ WELLNESS WEDNESDAY ]

"As HIV-infected individuals live longer with potent antiretroviral therapy, metabolic complications such as low bone density and osteoporosis are increasingly recognized," says Michael Yin, MD, of Columbia University Medical Center in New York and lead author of the study. "Although numbers of HIV-infected postmenopausal women are increasing and postmenopausal women are at highest risk for osteoporotic fractures, few studies have evaluated skeletal status in this group. We hypothesized that postmenopausal women might be particularly vulnerable to the adverse effects of HIV infection or ART on the skeleton and our results indicate that this may indeed be the case."

"HIV infection was independently associated with lower bone-mineral density after adjusting for body mass index and traditional osteoporosis risk factors," says Yin. "While the reason for HIV-associated bone loss remains unclear, it may be related to increased levels of cytokines [proteins produced by cells that aid communication between cells], direct effects of antiretrovirals on bone cells or hormonal/nutritional deficiencies that are common in HIV."

"Estrogen protects against the effect of cytokines on bone resorption," Yin adds. "Therefore, as HIV-positive women become estrogen-deficient during menopause, they may be at higher risk for accelerated bone loss and fracture."