Bone mineral density in people living with HIV : a narrative review of the literature
CITATION: Kruger, M. J. & Nell, T. A. 2017. Bone mineral density in people living with HIV : a narrative review of the literature. AIDS Research and Therapy. 14:35, doi:10.1186/s12981-017-0162-y.
The original publication is available at https://aidsrestherapy.biomedcentral.com
Bone health status is largely absent in South Africa, the main reasons being the absence and cost-effectiveness of specific screening equipment for assessing bone mineral density (BMD). Various risk factors seem to play a role, some of which can be modified to change bone health status. Urbanisation is also a public health concern. Changing nutritional, as well as social behaviour, play integral roles in the prevalence and incidence of decreased BMD. Furthermore, human immunodeficiency virus (HIV) specifically, has a negative impact on BMD and although highly active antiretroviral therapy increases the prognosis for HIV-infected individuals, BMD still seem to decrease further. Dual energy X-ray absorptiometry is considered the gold standard for BMD assessment; however, recent developments have provided more cost-effective screening methods, among which heel quantitative ultrasound appears to be the most widely used in resource limited countries such as South Africa.