Preventing Antiretroviral Therapy–Induced Bone Loss in HIV Patients

After initiation of antiretroviral therapy (ART), HIV-infected patients experience substantial declines in bone mineral density (BMD). The largest losses occur in patients who initiate a tenofovir disoproxil fumarate (TDF)-containing regimen, but even those who start more bone-friendly medications, such as abacavir or tenofovir alafenamide, suffer declines.

To assess whether giving a bisphosphonate, which inhibits bone resorption, can prevent ART-induced BMD loss, investigators conducted a randomized, controlled, double-blind, phase IIb trial involving 63 HIV-infected patients initiating ART treatment with TDF/FTC plus ritonavir-boosted atazanavir. Most participants were black (84%) and male (79%), and 67% were current smokers (a risk factor…