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Osteoporosis and HIV

stages of hiv infection

People living with HIV have more incidences of bone mineral density loss and fragility fractures, but the exact cause of that has yet been determined.

What are osteopenia and osteoporosis?

As we age we gradually lose bone density, meaning that our bones do not renew themselves as quickly as they do during childhood and early adulthood.

If your bones become too thin and brittle you can develop osteopenia. This condition has no noticeable symptoms but if your bones weaken further it can lead to osteoporosis which increases your likelihood of broken bones and fractures.

Many older people develop osteoporosis.

Risk factors for osteoporosis include:

Women are prone to developing osteoporosis after the menopause.

Does HIV cause bone problems?

People living with HIV have more incidences of bone mineral density loss and fragility fractures. Opinion is divided on whether this is because of the virus itself – however, bone mineral density has been found to decline a couple of years after starting antiretroviral treatment.

If you are aged over 40 you should be screened for a risk of bone fractures. DEXA scanning should be offered by your HIV clinic if you are a post-menopausal woman, a man aged over 50 or if you are at a high risk of fractures, whatever your age.

DEXA scans are a type of X-ray which can identify bone density loss. If you have osteopenia you will be monitored so that you can take treatment if you go on to develop osteoporosis.

How is osteoporosis treated?

NHS Choices has a lot of information about treatments for osteoporosis. They state that if you develop osteoporosis, bisphosphonates can slow down the rate at which bone is broken down. You can combine treatment with lifestyle changes which should make bone breakages less likely.

Increasing the amount of weight bearing exercise you take can increase your bone density, this includes activities such as walking, dancing or low impact aerobics. Exercise such as swimming and cycling is not weight bearing, but is great for the heart and lungs and building muscle strength. This will improve your balance and co-ordination, reducing your risk of falls.

It is best to get advice from a doctor or physiotherapist at your clinic before starting an exercise programme. This is because the type of exercise recommended may vary depending on your level of bone density loss and whether you have had any fractures or not.

Eating a healthy and balanced diet will help you get all the vitamins and minerals you need and help to strengthen your bones. It is important to eat enough food containing calcium - which strengthens bones - and vitamin D which helps you body absorb calcium. Sunshine can also increase your levels of vitamin D. The National Osteoporosis Society suggests that getting around 10 minutes of sunshine once or twice a day on bare skin (without sunblock, but taking care not to burn) will help your body make vitamin D.

It may be a good idea to book an appointment with a dietician and physiotherapist at your HIV clinic to get further advice.

Further help and information:

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The Information Standard: Certified member

This article was last reviewed on 20/2/2015 by Anna Peters

Date due for the next review: 20/2/2018

Content Author: Kerri Virani

Current Owner: Health promotion

More information:

Bone health, i-base, July 2012

What is Osteoporosis, National Osteoporosis Society

Factors that increase your risk of osteoporosis and fractures, National Osteoporosis Society

Healthy bones, National Osteoporosis Society

Exercising with osteoporosis: Stay active the safe way, Mayo Clinic (2010)

Bone loss common in patients with HIV, and often progresses, NAM aidsmap (2010)

Continued antiretroviral therapy reduces bone mineral density in SMART study, NAM aidsmap (2008)

Exercise For Healthy Bones, National Osteoporosis Foundation (2011)

Bone loss, NAM aidsmap, March 2011

Keeping your bones healthy, NHS The Shrewsbury and Telford Hospital NHS Trust

Exercise and bone health, NHS Choices, March 2014

Screening for bone fracture risk should be routine for over-40s with HIV, new guidelines recommend, Keith Alcorn, NAM aidsmap, February 2015

Osteoporosis - Diagnosing osteoporosis, NHS Choices, April 2014

Osteoporosis - Treatment, NHS Choices, November 2013

Osteoporosis - Overview, NHS Choices, April 2014

Healthy Living for Strong Bones, National Osteoporosis Society, 2014

Exercise and osteoporosis, National Osteoporosis Society, 2014