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Screening for bone fracture risk should be routine for over-40s with HIV, new guidelines recommend
Keith Alcorn, 2015-02-02 14:40:00
Screening for fracture risk should be a routine part of HIV
care for all over-40s, and all postmenopausal women, all men over 50 and people at high
risk for fractures of any age should undergo DEXA screening (a type of X-ray) to assess bone mineral density
and their need for treatment, experts on bone disorders recommend in new
guidelines published online in the journal Clinical
Low bone mineral density and fragility fractures occur more
frequently in people living with HIV than in other people of a similar age.
Several studies conducted in US men and women living with HIV have shown that
the rate of fractures of the spine, hip and wrist is approximately 60% higher
than in the general population.
It is unclear whether
HIV causes bone mineral loss, also known as osteoporosis, but bone mineral
density usually declines by 2- 6% in the first two years after starting antiretroviral
treatment. People living with HIV also tend to have a high frequency of risk
factors for osteoporosis including smoking, high alcohol consumption, low body
weight and poor nutrition. As the population of people living with HIV ages,
bone mineral loss is becoming a more serious problem.
International expert guidelines for management of bone loss
were developed by 34 experts from 16 countries. Their recommendations cover
screening, diagnosis and monitoring of bone disease and are graded accorded to
the strength of evidence available.