Osteoporosis

Osteoporosis affects approximately 1 million Australians, and is characterised by weakening of the bones and reduction in bone mineral density. This makes them fragile and more prone to fracturing, with even small amounts of trauma. 

As active organs, bones are constantly turning over and remodelling, to provide a framework for our muscles, protect our organs, and maintain calcium and phosphate levels in the bloodstream. Decreased bone mineral density occurs when the bones lose minerals, including calcium, more quickly than they can be replaced. It is normal to lose some bone mass and strength during the aging process; 20% of women and 5% of men over the age of 50 have osteoporosis, whereas 40% of women, and around 10% of men over the age of 70 have osteoporosis.  

 

Importance for PLHIV50+

Risk factors for osteoporosis include age, sex, and genetics. Other important factors can lead to low bone density and osteoporosis, including nutritional deficiencies, like low calcium or vitamin D; excessive alcohol and cigarette smoking; hormone disorders like thyroid disease, low testosterone or early menopause; chronic medical conditions, like chronic kidney or liver disease, rheumatoid arthritis, and inflammatory bowel disease; and low physical activity. 

People living with HIV (PLHIV) experience a higher rate of osteoporosis and fractures when compared with the general population. This is likely a result of the virus itself, chronic inflammation, and some antiretroviral medications. Higher rates of smoking and alcohol use among PLHIV also plays a role, too.  

 

Diagnosis

There are no specific symptoms of osteoporosis. Often, osteoporosis is diagnosed after a minimal trauma fracture, with fractures to the hip, wrist and spine being most common. When fractures do occur, they can have significant impact on a person’s quality of life. Sometimes, the diagnosis Is made by your doctor after a Bone Mineral Density test (also called a DEXA scan). The goal of treatment is to help maintain or increase bone density, and reduce the risk of fractures occurring. Lifestyle factors are also important to reduce bone loss.