What is it about?

A sizable proportion of adults living with HIV (PLHIV) have been on anti-retroviral treatment (ART) for over a decade, yet relatively little is known about the impact of anti-retroviral medication on the bone health of these individuals. This study therefore set out to determine the proportion of people with reduced bone quality following long-term exposure to antiretroviral therapy in Ugandan people living with HIV. One hundred ninety-nine PLHIV that had been receiving ART for at least 10 years participated in this study. All participants had bone scanning to determine the quality of their bones. The data collected included antiretroviral drug history and behavioral risk data. The average age of the participants was 39.5 years and participants had been receiving antiretroviral medication for an average of 12.1 years. The HIV was undetectable in 178 participants. Thirty-six participants (18%) participants had reduced bone quality. Participants with normal or above normal weight was associated with good bone quality. The duration on and exposure to the various antiretroviral medications had no significant effect on the participant’s chance for developing poor bone quality.

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Why is it important?

Our findings provide additional evidence that patients on long term antiretroviral treatment achieve bone stabilization. Maintaining adequate body weight is important in maintaining good bone health in PLHIV on antiretroviral therapy.


Some antiretroviral medications negatively affect bone quality; and this may predispose patients to fractures. Our findings suggest that maintaining of good body weight may protect the bones from the negative effects of anti-retroviral treatment. There is a need to develop guidelines and protocols for the prevention and treatment of poor bone quality not only in HIV, but also in the general public in low and middle income countries.

Erisa Mwaka
Makerere University

Read the Original

This page is a summary of: Low bone mass in people living with HIV on long-term anti-retroviral therapy: A single center study in Uganda, PLoS ONE, February 2021, PLOS, DOI: 10.1371/journal.pone.0246389.
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