Early Anti Retroviral Therapy may lead to bone loss in patients with HIV

Prof Dr,DRAM,HIV /AIDS,HEPATITIS ,SEX DISEASES & WEAKNESS expert,New Delhi,India, +917838059592

For better care of HIV patients now throughout the world patient is provided Anti Retro Virus therapy as soon as HIV is diagnosed irrespective of Viral load and CD4 count,previously ART or ARV or HAART treatment was provided to patient after doing CD4 count .Initially ARV was being provided free of cost in Government set up through ART centre established in many District hospitals and medical colleges and in private by HIV Doctors writing medicines.patient is asked to come everymonth to ART centre with empty box of these ARV medicines and for next month usually 03 drugs provided either separately or in a combined pill box so that there is a better compliance and control of Disease.gradually CD4 count considered was below 350 and recently changed to below 500.But now WHO states that provide ARV as soon as HIV is diagnosed,our country has also adopted it for few patients in ares like Mizoram and Nagaland.

A recent study has found that early antiretroviral treatment (ART) at the time of diagnosis may lead greater bone loss compared with deferring ART.

The study followed 399 participants (195 immediate ART and 204 deferred ART) for an average of 2.2 years.Although the study revealed a negative effect on bone density of immediate ART, the overall benefits of ART for preventing HIV transmission and adverse health outcomes prevail.

                  It will be important to understand the long-term consequences of reductions in bone mineral density associated with ART and whether these reductions continue or stabilise with longer therapy.Prof. Jennifer Hoy, lead author of the Journal of Bone and Mineral Research, said, "What we found was that starting treatment is also associated with accelerated bone loss of about 2-4%, and the rate of decline then appears to slow after the first 2 years of treatment, compared with HIV positive people who deferred treatment."

         Adding, "We have no cure for HIV, so antiretroviral treatment is for life. An increased rate of bone loss may become important years later, in the setting of increased risk of fragility fracture."

The study was published in Journal of Bone and Mineral Research.