Osteoporosis and HIV

For over three decades, HIV has been a high topic of discussion. Osteoporosis however, has been around since the dawn of time. In fact, they have found bone remnants of ancient man showing clear signs of loss of bone density – bones well on their way to developing the latticework of delicacy that is the hallmark of the disease. The interesting thing about these old bones is that their owners weren’t that old.

Our ancient cousins rarely lived beyond the age of 40, so the emergence of the condition at a much younger age highlights the difference in diet and lifestyle of our ancestors. Consider the fact that they must have spent an inordinate amount of time creeping about in the dark with only an occasional good meal, and – when not flinging themselves violently about with a spear – they would have been huddled together in small spaces

Sneakily though, osteoporosis still lurks in the background of all our bones – but today awareness and action make things a lot more difficult for it to make an impact on our lives, especially at such young ages. Diet, exercise, supplements all make a difference in how we experience the disease today, and sometimes only at advanced ages, and particularly after menopause for women.

Osteoporosis is a disease that causes bones to become weak, breaking easily at such vital points as the hip, spine and wrist. Nevertheless, we rarely fuss about our bones – unlike the attention we pay our digestive process, complaining at every unhappy twinge or gurgle, completely unaware that every event in the body can affect another part, not least the bones.

This is curious considering the human body is made up of more than 200 bones, from the skull to the bones of the toes, and we depend on just about all of them to hold us up. Bones help us move, and protect our internal organs, such as the heart, liver, and brain. So you’d think we would pay a bit more attention; we can do without a colon apparently, but imagine having to get rid of your bones. You would look very odd – except perhaps for politicians who seem to manage very well without their spines.

Factoring in osteoporosis

There are many factors that increase the risk of osteoporosis, and recently the discussion has included the HIV factor. The argument thus far, is unresolved. There are signs that people with HIV are possibly more vulnerable to the development of osteoporosis. But then there is much debate as to whether it is the condition of HIV itself that is responsible, or the medication. Also, in many instances, the medication for HIV is helping more people to survive for longer, and therefor they are perhaps just developing osteoporosis because they are growing older in the natural way, nothing to do with HIV or the medication in the first instances.

While the question remains regarding the link between HIV and osteoporosis, some experts believe there is evidence that bone loss may occur faster in people living with HIV than in people without HIV. Factors that increase the rate of bone loss in people with HIV may include:

  • HIV infection itself.
  • Some HIV medicines.
  • Family history: Reduced bone mass tends to run in families.
  • Smoking and drinking.
  • Taking other medicines for a long time (steroids or antacids).
  • Older age. HIV medicines are helping people with HIV live longer, and advancing age increases the risk of osteoporosis.
  • Symptoms of HIV

Symptoms vary from person to person. The only way to be sure whether you have HIV is to have an HIV test. You cannot tell from symptoms alone because these are often purely from general causes. Very often the first indication of HIV may be a short, flu-like illness, often called a ‘seroconversion’ illness, which includes a fever, sore throat, swollen glands, aches and pains, and a blotchy rash.

After this initial illness, it’s not uncommon for people to live with HIV and not have any symptoms at all. But eventually the virus causes enough damage for people to become ill with a range of symptoms such as: fevers and night sweats; a high temperature; a cough that won’t go away; unexplained weight loss; severe diarrhoea; bad headaches; or persistent mouth and skin problems. At this point, none of these include loss of bone density.

Taking the right action once you know your status

So remaining bone healthy once diagnosed with HIV should include taking the usual steps to prevent or ameliorate osteoporosis:

Check for osteoporosis via a bone mineral density test. This should be advised for all people living with HIV, but discuss this option with a health care provider.
Eat a healthy diet rich in calcium and vitamin D. Foods high in calcium include dairy products, such as milk, yogurt, and cheese. Other foods high in calcium include dark green leafy vegetables, such as collard greens, bok choy, kale, and broccoli. Sardines, tofu, and almonds should also be on that list. Choose milk fortified with Vitamin D. Certain fish and mushrooms are also high in Vitamin D.
Take the recommended supplements in calcium and Vitamin D.
Weight-bearing exercises, such as weight lifting, walking, and dancing, can make bones stronger and help slow the rate of bone loss.
Make sure you don’t smoke and keep alcohol to the minimum.

Love your bones! Whether in sickness or in health, they are married to you for life – so take care of them!

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

Find out more about our work at: www.osteoporosis.org.za