Rates of low bone mass are greater in adolescent males with HIV than in adolescent females with HIV, according to research published in the Journal of Acquired Immune Deficiency Syndromes.

A team of researchers studied 11 biomarkers associated with inflammation, bone loss, and bone formation in 450 subjects assessed by sex and HIV status. Grace Aldrovandi, MD, chief of the Division of Infectious Diseases at the Children’s Hospital Los Angeles, and colleagues found that HIV-infected male adolescents had increased levels of macrophage activation marker sCD14.

“HIV-infected males had increased levels of soluble CD14 which inversely correlated with bone mineral content and bone mineral density measures,” wrote Dr Aldrovandi, “suggesting macrophage activation as a possible mechanism of differential bone loss.

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“Despite higher levels of general inflammation in HIV-infected females, HIV-positive males in our study showed both lower bone mass and higher sCD14 levels,” Dr Aldrovandi added. The researchers noted that one possible explanation is the protective nature of estrogen against some types of inflammation seen in chronic HIV.

“We hope that interventions to decrease macrophage activation early in HIV infection will decrease associated bone loss, which has become a major adverse side effect of HIV infection and its treatment,” concluded Dr Aldrovandi.


  1. Ruan A, Tobin NH, Mulligan, K et al. Macrophage activation in HIV-infected adolescent males contributes to differential bone loss by sex: Adolescent trials network study 021. JAIDS. 2016; doi: 10.1097/QAI.0000000000000953