Case review of 3 patients with musculoskeletal manifestation of human immunodeficiency virus and highly active antiretroviral therapy in the form of osteopenia and insufficiency fractures.

Patients infected with human immunodeficiency virus are prone to develop multiple complications related to the musculoskeletal system with aetiologies including infection, inflammatory, neoplastic, and coagulopathy, of which infection is the most common.1 The underlying mechanisms leading to these diseases are complex and multifactorial. Antiretroviral drugs have helped to reduce the burden of complications; however, they may pose several adverse effects. We have tried to draw attention to the impact of intake of nucleoside reverse transcriptase inhibitor-class drugs (like tenofovir), which is implicated in severe osteoporosis, multiple insufficiency fractures, and osteonecrosis.2 , 3 Radiology plays an important role in early diagnosis and treatment planning in these patients, in whom clinical and laboratory findings are commonly equivocal and non-specific.