Drinking takes toll on bones of people with HIV

Any amount of alcohol consumption increases the risk of osteoporosis in people with HIV, a new report suggests.

Researchers analysed data from a long-term study of 198 people with HIV and a current or past alcohol or drug use disorder.

In these people, any alcohol consumption was associated with lower levels of a protein involved in bone formation, putting them at increased risk of the bone-thinning disease, osteoporosis, the Boston University (BU) researchers said.

"We did not find an amount of alcohol consumption that appeared 'safe' for bone metabolism," said lead author Dr Theresa Kim. She's a faculty member of the Clinical Addiction Research Education programme at Boston Medical Center.

Low bone density

"As you get older, your ability to maintain adequate bone formation declines," said Kim, who is also an assistant professor at BU School of Medicine. "These findings suggest that for people with HIV, alcohol may make this more difficult."

The study was published in the journal Alcoholism: Clinical and Experimental Research.

Low bone density is common among people with HIV, even those on antiretroviral therapy who have suppressed levels of the virus, the study authors explained in a university news release.

Study senior author Dr Richard Saitz, a professor of community health sciences at BU School of Public Health, said, "Our finding highlights an under-recognised circumstance in which people with HIV infection often find themselves: Their viral load can be well controlled by efficacious, now easier-to-take medications, while other health conditions and risks that commonly co-occur – like substance use and other medical conditions – are less well-addressed."

Modifiable risk factor

Kim said the findings are instructive to her as a primary care physician in the Boston Health Care for the Homeless Program.

"If I were counselling a patient who was concerned about their bone health, besides checking vitamin D and recommending exercise, I would caution them about alcohol use, given that alcohol intake is a modifiable risk factor, and osteoporosis can lead to fracture and functional decline," she said.

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