Hi Dr Moyle, l have been hiv pos for 7 months and currently not on meds, my cd4 465 and viral load 20,000 but l have lost heaps of muscle of the back of my legs and buddocks, but the problem is my leg which l badly broke as a kid, l am 35 years old now.. and the bone where l broke my leg hurts and l have lost width across my shoulders, but l still go to the gym and try and stay heathy, what can l do about my bones to keep them strong ???

thank you steven

Dear Steven The effects of HIV and medications on bones is a source of debate. The generally consensus would be that as HIV advances and health deteriorates you may lose some bone density. Medications generally have a neutral effect although bone loss may continue at least initially in the face of treatment. There are many other important risk factors for bone loss: smoking, high alcohol intake, lack of physical activity, lack of vitamin D from sunshine or milk, low testosterone and other hormonal abnormalities. Some of these thinks can be checked occasionally with your doctor and it is worth checking with you doctor about you muscle loss, something we would not expect to be HIV related in someone with such good numbers as you. Broadly the answer is to keep up a high level of physical activity, a nutritious diet and avaoid smoking and limit alcohol intake and you bone should stay strong.

Best Wishes Dr Moyle