HIV and Bone Loss in Infected Young Men
Certain physiological occurrences are expected for patients who are infected with HIV. Bone loss is one of the effects that tops the list. It has been documented that those with the disease are more likely to present with fractures than someone who is not HIV-positive. High rates of osteoporosis and osteopenia are not new. However, recent research shows a discrepancy between the sexes in this matter. Further investigation revealed some information that could prove helpful for physicians as they treat HIV-positive individuals.
The most noticeable difference is the percentage of men versus the percentage of women who present with osteoporosis or osteopenia. Men actually have a much higher rate of the condition than women. It is estimated that 90% of HIV-infected men have bone loss while females with HIV come in around 60%.
HIV causes chronic inflammation due to disruption and dysfunction of the immune system. Antiretroviral therapies also add to the body’s burden of maintaining bone mass. These conditions are known to slowly erode bone. Studies show that in preteen and teenage males, there is an increase of what is called macrophages. These white blood cells, when found in the bone, are responsible for resorption during remodeling of the bone when it is continuous.
Predicting and Preventing Bone Loss
Digging a bit deeper, the more of these specialized cells there were, the less dense the bone material proved to be. If the production of the macrophages increases, it seems to indicate bone loss. It is hoped that with this information, newly infected patients can be watched for these types of changes, and thereby the amount of bone lost can be reduced.
For the feminine side, chronic inflammation generally is more prevalent in females. However, due to the presence of estrogen, the rate of bone loss is lessened. Estrogen acts as a shield against some of the inflammation. Estrogen is also effective at blocking the production of macrophages. These two properties together seem to account for the lower figures of bone loss in females when compared to males.