Evaluation of Bone Mineral Density, Microarchitecture, and Detection of Fractures on Young Patients Living with Human Immunodeficiency Virus: when and How to Screen?

People living with the human immunodeficiency virus (PLWH) developed higher life expectancy along with chronic bone disease over the past years. Our purpose is to evaluate bone mineral density, bone microarchitecture and fractures in young PLWH and understand the disease’s contribution to bone derangements and fracture risk. Eighty-one HIV-infected and 54 control young (20–50 years) male and female subjects were enrolled in this study. Methods for patient evaluation included DXA-VFA (dual energy X-rays and vertebral fracture assessment), HR-pQCT (high resolution peripheral quantitative computed tomography), biochemistry and FRAX. Fifty participants from each group completed all exams. Median age was 40 (25–49) vs. 36.5 (22–50) for the HIV and control groups, respectively (p 0.120). Ethnicity, body mass index, serum phosphorus, 25-hydroxyvitamin D, PTH and CTX were similar between groups, although ALP and OC suggested higher bone turnover in PLWH. VFA identified morphometric vertebral fractures in 12