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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since the advent of potent antiretroviral therapy in combination regimens, multiple epidemiologic studies have shown that osteopenia and osteoporosis are common among patients with HIV infection. However, there remain many areas of uncertainty about this potential complication, which can be confusing for the HIV clinician. This review summarizes the epidemiology, pathophysiology, suggested screening strategies, and management options of decreased bone mineral density in patients with HIV. Our aims are to review the available data, highlight controversial issues, and provide guidance for clinicians where supporting data are unavailable.
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PMID:Osteopenia and osteoporosis in patients with HIV: a review of current concepts. 1652 53

Several of the physical symptoms and illnesses related to HIV disease and its treatment--such as fatigue, weight changes, memory loss, depression, and atherosclerosis--mimic typical age-related health problems. It is estimated that at least 10% of HIV positive people in the United States are 50 years of age or older--a number that will certainly increase as people with HIV live longer thanks to effective antiretroviral therapy. For older women, sorting out the interplay between HIV, aging, and the side effects of medications can be very difficult. Many health problems are exacerbated by smoking, obesity, and poor health behaviors that can lead to an increased risk of illness or death. This article addresses two common health risks in aging women with HIV: heart disease and osteoporosis.
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PMID:Women and HIV. Aging with HIV. 1661 Jan 17

The advent of highly active anti-retroviral therapy (HAART) has dramatically decreased the rate of AIDS-related mortality and significantly extended the life span of patients with AIDS. A variety of metabolic side effects are associated with these therapies, one of which is metabolic bone disease. A higher prevalence of osteopenia and osteoporosis in HIV-infected patients receiving anti-retroviral therapy than in patients not on therapy has now been reported in several studies. Several factors have been demonstrated to influence HIV-associated decreases in bone mineral density (BMD), including administration of nucleoside reverse transcriptase inhibitors (NRTIs). In this article, discussion will focus on the molecular pathogenesis and treatment of HAART-associated osteopenia and osteoporosis.
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PMID:Pathogenesis of osteopenia/osteoporosis induced by highly active anti-retroviral therapy for AIDS. 1683 30

An HIV-1 infected patient on dual protease inhibitor treatment developed spontaneous vertebral fractures and avascular necrosis of the femoral bone after receiving combined chemotherapy for Burkitt's lymphoma including short-term prednisolone. The factors involved in the pathogenesis of osteopaenia and osteoporosis in this case are discussed and we propose the need for guidelines in order to reduce the incidence of such events in HIV-infected patients in the future.
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PMID:Severe osteoporosis and multiple fractures in an AIDS patient treated with short-term steroids for lymphoma: a need for guidelines. 1692 9

Bone disorders such as osteopenia, osteoporosis, osteomalacia, and osteonecrosis have been reported in persons infected with HIV. Any specific contributions of HIV infection and its treatment to these disorders are unclear. The prevalence estimates vary widely among studies and may be influenced by the presence or absence of antiretroviral therapy, wasting and lipodystrophy, severity of HIV disease, and overlapping established bone mineral loss or osteonecrosis risk factors. Limited data exist regarding the consequences of HIV treatment choice and treatment modification on bone mineral density (BMD) outcomes. Available data suggest that while BMD may initially decline modestly afer the start of antiretroviral therapy, there is then a gradual recovery in BMD over time. This may reflect the observation that BMD declines as HIV disease progresses and that this decline may be arrested and partially corrected with successful antiretroviral therapy.
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PMID:Bone mineral abnormalities in persons with HIV infection: signal or noise? 1693 75

Rheumatic complaints are common in patients with HIV, and HIV positivity confers an increased susceptibility in populations with similar risk factors for HIV infection. With the advent of the modern combined antiretroviral treatment, HAART has had a profound beneficial effect on survival in HIV-infected patients, with lifelong control of HIV infection and normalization of life expectancy; but it has also contributed to both an altered frequency and a different nature of rheumatic complications now being observed in this population, with new rheumatic complications, such as osteoporosis, osteonecrosis, gout, mycobacterial, mycotic osteoarticular infections, and neoplasia perhaps more prevalent. Rheumatologists, internists, and general physicians need to be aware of these changes to provide optimal diagnosis and how to disclose the results to their patients. They also need to be familiar with the management of HIV infection and to direct careful attention to the prevention of HIV transmission in health care facilities.
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PMID:Rheumatic manifestations of human immunodeficiency virus infection. 1711 95

The course of HIV-infection has changed dramatically since the beginning of the epidemic. Opportunistic infections and AIDS-defining tumors are diagnosed less frequently since the introduction of antiretroviral therapy and the time of survival has increased. According to German-Austrian therapy guidelines highly active antiretroviral therapy (HAART) should be started on the onset of HIV-related symptoms and/or when the CD4 cell count is lower than 350/microl. Patients should be treated in specialized centres because of the complexity of HIV-infection and its therapy. For monitoring CD4 cell counts and viral load are determined. Reasons for therapeutic failure can be drug interactions, resistance or compliance problems. Although HIV-infection is often compared to insulin dependent diabetes mellitus psychological and social impact on HIV patients is still high. Increasing viral multi-drug resistance, long-term toxicity like lipodystrophy, osteoporosis and cardiovascular disease are only some problems HIV-infected patients are facing in the next years. In Germany 600 to 700 patients still die because of AIDS every year.
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PMID:[HIV-related symptoms]. 1711 97

Today, there is reasonable agreement about the frequent association between osteopenia/osteoporosis and HIV infection. Opinions about the aetiopathogenesis of osteopenia and osteoporosis during HIV infection are really divergent. Some authors suggest that bone dysmetabolism is related to the HIV infection itself. The loss of bone mineral density (BMD) occurs in two-thirds of HIV-1-seropositive individuals naive to antiretroviral therapy (ART), and improves during the follow-up of patients receiving ART, independently from the drug class used. Moreover, a reduced BMD has also been associated with both ART-induced lipodystrophy and mitochondrial toxicity. Several authors have observed an association between HAART and osteoporosis; however, methodological bias, particularly the lack of control groups, could have obscured the data. Today, the role of HAART on bone metabolism and on BMD in HIV-seropositive patients is still controversial. The available data on BMD studies after the introduction of HAART are much more contradictory than those from before this era. The variety and complexity of changes in bone metabolism in patients with HIV infection and the different pathomechanisms leading to changes in bone mass, as well as the different stages of disease at the time of clinical investigation, may contribute to the contradictory data on BMD measurements in HIV-infected patients after HAART.
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PMID:[Multifactorial relations between HIV, HAART and bone metabolism]. 1712 25

There is considerable current interest in the design of encodable molecules that regulate intracellular protein circuitry and/or activity, ideally with a high level of specificity. Src homology 3 (SH3) domains are ubiquitous components of multidomain signaling proteins, including many kinases, and are attractive drug targets because of the important role their interactions play in diseases as diverse as cancer, osteoporosis, and inflammation. Here we describe a set of miniature proteins that recognize distinct SH3 domains from Src family kinases with high affinity. Three of these molecules discriminate effectively between the SH3 domains of Src and Fyn, which are expressed ubiquitously, and two of these three activate Hck kinase with potencies that rival HIV Nef, one of the most potent kinase activators known. These results suggest that miniature proteins represent a viable, encodable strategy for selective activation of Src family kinases in a variety of cell types.
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PMID:Encodable activators of SRC family kinases. 1717 92

A relationship between haemophilia and osteoporosis has been suggested, leading to the initiative for a larger study assessing this issue. Bone mineral density (BMD) was measured by osteodensitometry using dual energy X-ray absorptiometry (DEXA) in 62 male patients with severe haemophilia A; mean age 41 +/- 13.1 years, mean body mass index (BMI) 23.5 +/- 3.6 kg m(-2). Using the clinical score suggested by the World Federation of Hemophilia, all patients were assessed to determine the severity of their arthropathy. A reduced BMD defined as osteopenia and osteoporosis by World Health Organization criteria was detected in 27/62 (43.5%) and 16/62 (25.8%) patients, respectively. Fifty-five of sixty-two (88.7%) patients suffered from haemophilic arthropathy. An increased number of affected joints and/or an increased severity were associated with lower BMD in the neck of femur. Pronounced muscle atrophy and loss of joint movement were also associated with low BMD. Furthermore, hepatitis C, low BMI and age were found to be additional risk factors for reduced BMD in the haemophiliac. Our data shows that in haemophilic patients osteoporosis represents a frequent concomitant observation. The main cause for reduced bone mass in the haemophiliac is most probably the haemophilic arthropathy being typically associated with chronic pain and loss of joint function subsequently leading to inactivity. Further studies including control groups are necessary to elucidate the impact of comorbidities such as hepatitis C or HIV on the development of osteoporosis in the haemophiliac.
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PMID:Osteoporosis in haemophilia - an underestimated comorbidity? 1721 29


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