Body
Adverse Effects | Associated ARVs | Onset/Clinical Manifestations | Estimated Frequency | Risk Factors | Prevention/Monitoring | Management |
---|---|---|---|---|---|---|
Osteopenia and Osteoporosis |
Any ARV regimen Specific Agents of Concern
|
Onset
Presentation
|
BMD z score Less Than −2.0
|
|
Prevention
Monitoring
|
|
a Drugs of greatest concern are TDF and EFV. Some experts measure 25-OH-vitamin D in children with HIV with additional risk factors, including living at high latitudes, sun avoidance, low dietary intake, and obesity (U.S. Preventive Services Task Force 2021 guidelines). b DXA scanning is not routinely recommended for children and youth who are being treated with TDF. DXA scanning can be considered for children and youth who are receiving additional medications which also affect bone density or have non-HIV related conditions for which DXA scans may be indicated (such as cerebral palsy). Key: 25-OH-vitamin D = 25-hydroxy vitamin D; ART = antiretroviral therapy; ARV = antiretroviral; ATV = atazanavir; BMD = bone mineral density; BMI = body mass index; COBI = cobicistat; DRV = darunavir; DXA = dual-energy x-ray absorptiometry; EFV = efavirenz; INSTI = integrase strand transfer inhibitor; IU = international unit; LPV = lopinavir; LPV/r = lopinavir/ritonavir; PI = protease inhibitor; RPV = rilpivirine; RTV = ritonavir; TAF = tenofovir alafenamide; TDF = tenofovir disoproxil fumarate |