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[Are bones in HIV-infected patient really fragile?].

Impact of HIV infection on bone is now well established, with a high prevalence of osteoporosis and osteopenia and an increase of fracture risk, up to 5 fold for hip fractures. Beyond the usual risk factors frequently reported in this population, HIV infection itself and antiretroviral treatment, especially tenofovir, are involved in the pathophysiology of bone loss. Vitamin D deficiency is frequent and should be corrected. Fracture risk can be assessed based on clinical risk factors, the FRAX tool and bone mineral density measurement by DXA. Treatment in patients at increased risk of fracture is based on the same principles as in the general population, with mainly bisphosphonates.