HIV感染已被报道会导致骨质丢失和骨折风险增加。在正常情况下，骨代谢受间充质细胞、单核巨噬细胞分化为骨吸收细胞（osteoclasts）、成骨细胞（osteoblasts）及其表达的调控因子（如RANKL、M-SCF和转化生长因子β）的调节。骨吸收和骨生成之间的平衡取决于骨吸收细胞和成骨细胞之间的平衡。此外，一些免疫细胞，如B细胞、T细胞和表达RANKL的其他非免疫细胞，在炎症条件下可能导致骨质疏松。HIV蛋白由三种类型组成：调控蛋白、辅助蛋白和结构蛋白，通过上调NF-κB的表达、肿瘤坏死因子α的含量以及炎性细胞因子的释放，它们在HIV介导的骨丢失中起到一定作用。更糟糕的是，尽管抗逆转录病毒疗法已经减少了HIV感染的死亡率，并成功将获得性免疫缺陷综合征转化为慢性病，但其对骨质丢失的影响不容忽视，尤其是当药物中包含替诺福韦时。本综述分析了一些研究报告，重点关注了由HIV感染和抗病毒治疗引起的骨生成和骨吸收不平衡导致的整体骨溶解情况。骨质丢失的内在机制为研究人员分析HIV患者并发骨质丢失的危险因素提供了参考，并帮助临床医生在HIV患者的临床治疗和慢性病管理过程中提供干预和预防骨质丢失的思路。版权所有：© 2023 Permanyer。

HIV infection has been reported to cause bone loss and a higher risk of fracture. Under normal conditions, bone metabolism is regulated by mesenchymal cells, osteoclasts differentiated from mononuclear macrophages, osteoblasts, and their expression of regulatory factors, such as receptor activator of nuclear factor-kappa B ligand (RANKL), M-SCF, and transforming growth factor-beta. The balance between bone resorption and osteogenesis depends on the balance between osteoclasts and osteoblasts. In addition, some immune cells, such as B-cells, T-cells, and other non-immune cells expressing RANKL, can contribute to osteoporosis under inflammatory conditions. HIV proteins consist of three types: regulatory proteins, accessory proteins, and structural proteins, which contribute to HIV-mediated bone loss partly by upregulating NF-κB expression, tumor necrosis factor alpha content, and release of inflammatory cytokines. Even worse, although antiretroviral therapy has reduced HIV infection mortality and successfully transformed acquired immunodeficiency syndrome into a chronic disease, its impact on bone loss should not be overlooked, especially when the drug contains tenofovir. This review analyzes some reports focusing on the overall osteolytic situation due to imbalances in osteogenesis and bone resorption due to HIV infection and antiviral therapy. The intrinsic mechanism of bone loss provides a reference for researchers to analyze the risk factors for HIV patients complicated with bone loss and helps clinicians to provide ideas for the intervention and prevention of bone loss during clinical treatment and chronic disease management of HIV patients.Copyright: © 2023 Permanyer.