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In HIV-infected patients, osteoporosis is present with an overall prevalence of about 15%, and it is more frequent than in the general population. Causes of bone disease have not been fully elucidated but maybe related to several factors including HIV infection per se or to the effect of antiretroviral drugs. To evaluate bone mineral density (BMD), dual-emission X-ray absorptiometry (DXA) scan has been suggested as gold standard. However, the introduction of quantitative calcaneal ultrasonography (CUS) may be a simple, sensitive and less expensive method to screen all patients but has not been validated in HIV-infected people. This study aims to perform a prospective evaluation of BMD by DXA and CUS in a cohort of HIV-infected patients before and during antiretroviral therapy, to explore the possible relationship among BMD and other osteoporosis markers such as vertebral fractures and bone-turnover markers and to identify antiretroviral drugs involved in osteoporosis worsening.
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