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Contradictory results
to the present HIV treatment guidelines found; early initiation of ART was
associated with greater bone loss as compared to delayed ART.
Anti-retroviral
therapy has led to a significant decline in mortality of individuals infected
with human immunodeficiency virus (HIV). According to latest HIV treatment
guidelines, antiretroviral treatment (ART) should be initiated at the time of
diagnosis. A recent study has revealed that early ART can cause more
significant bone loss compared with deferring ART.
This study followed 399 participants (195 received immediate ART and 204
deferred ART) for an average of 2.2 years.
The study determined an adverse effect on bone density in patients on immediate
ART. But the overall benefits of ART for preventing HIV transmission and
adverse health outcomes outweigh this adverse effect.
It is essential to study the long-term results of the association of reduced
bone mineral density and ART. To understand whether these reductions continue
or stabilize with more prolonged therapy.
Prof. Jennifer Hoy, lead author of the study said "What we found was that
starting therapy is also correlated with accelerated bone loss of about 2-4%,
and the rate of decline then seems to slow after the first 2 years of
treatment, compared with HIV positive people who deferred therapy,".
"We have no remedy for HIV, so antiretroviral therapy is for life. An
increased rate of bone loss may become essential years later, in the setting of
increased risk of fragility fracture.'
Wiley
Early antiretroviral therapy linked with bone loss in patients with HIV
Veronese N et al.
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