Management of Bone Disease and Body Composition Changes

  • Author: Donald P. Kotler, MD (More Info)
  • Section Editor: Eric S. Daar, MD
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 5/7/18 (What's New)

Introduction

  • ART has been associated with markedly diminished morbidity and mortality[Palella 1998]
    • Development of treatment-related complications diminishes the therapeutic benefits of ARVs
  • Several host and other confounding factors related to treatment-associated complications have been identified
    • Host factors: age, sex, race, family history, BMI, diet, exercise, tobacco use
    • Disease factors: duration, severity of immune depletion, magnitude of immune reconstitution
    • Other factors: difficulty obtaining clinically relevant measurements, difficulty distinguishing HIV effects from those of normal aging
  • Although the prevalence and severity of treatment-associated toxicities have decreased in the developed world, the incidence is higher in the developing world, primarily because of the use of older ARVs and less-aggressive treatment of comorbidities[Subbaraman 2007; Murphy 2007]
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