Osteomalacia & Osteoporosis in People with HIV

Osteomalacia:

 - Decreased bone matrix mineralization. In people with HIV (rare): have been a/w TDF renal PO4 wasting, vitamin D deficiency (from multiple causes)

 - Bone pain/tenderness (back, legs, ribs), Proximal muscle weakness, waddling gait

 - XRay: Osteopenia, Looser's pseudofracture

 - Lab: Decr Ca, Decr PO4, Incr ALP, 25-OH-D <10, Incr PTH

 - Tx: Vitamin D, Tx of underlying cause; usual reversible

Osteoporosis:

 - Loss of bone mass. In people with HIV (more common): multifactorial (viral effect, traditional risk factors, antiretroviral therapy)

 - Commonly asymptomatic

 - XRay: Osteopenia

 - Lab: Normal, mild-mod vitamin D deficiency

 - Tx: Bisphosphonates; varying response



by WuidQ: Washington University ID Questions @WuidQ



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