Viread, sports, and fractures

[leximancer]

I have a concern regarding the adverse effects Viread may have upon my relatively active lifestyle.  Perhaps the more experienced members here on this forum could help me with professional and anecdotal expertise?

Some background information: I am a 25 year old Asian-American male and have been positive for a little more than two years.  My current cd4 count is at 250 (22.7%), on a pretty consistent downward trend since a year and a half ago.  My viral load is currently at 3560, also on a pretty constant downward trend, logarithmically speaking, since a year and a half ago.

I am currently in relatively good health and am pretty active as well.  Depending on the season, I swim or bike.  Regardless of the time of year, I hike, backpack, and train with swords.  I have not had a broken bone in my life.  But I have recently taken up parkour, an art/discipline/sport that incorporates a lot of high-impact activities, such as running, landing (safely!) from high places, and vaulting over obstacles.^{[1], [2], [3]}  These movements often place strain on the wrists, feet, ankles, and knees.  To train for parkour, I have drastically increased the amount of resistance conditioning I engage in.

Now, here comes the part that pulls in HIV medications.  I have been told by my doctor that it is time to begin HAART.  He asked that I look at the side effects of Epzicom (Epivir + Ziagen) and Truvada (Emtriva + Viread) and choose one as my NRTI combination.  As I was doing so, I found that Viread has been linked to thinning bones.^{[4], [5], [6]}  I don't know whether it is an added risk factor, by my mother also suffers from osteoperosis.  This is a particular concern because I very much wish to continue training in parkour, but I fear that weaker bones may result in horrendous fractures every time I try to land a jump.  I would really rather not give it up, because the balance and control parkour teaches gives me a sense of control over my body — a feeling I've been sorely lacking over the past two years.

I did not find anything in the AIDsmeds.com bones lesson about effects on active lifestyles.  Has anyone else who has taken Viread (or Truvada) experienced loss of bone integrity to the point of not being able to engage in sports?  Is my increased resistance training or perhaps calcium and vitamin D supplements enough to counteract the effects of Viread on my bone tissue?  Is there anything else I can do to stop the decay of my bones if I do in fact choose to start taking Viread?

I appreciate any input anyone can contribute.

[Miss Philicia]

My doctor had me take calcium daily because I'm on Truvada, but keep in mind I'm also 42 and have been infected for 20 years, and on HIV meds for 15 of those.  Also, I was on Viread by itself in the 90's for many years, and now on Truvada for the past 3 years so I guess that's a bit.

Otherwise, I've certainly not heard of lots of this issue either with people I know or here on the boards, meaning instances of fractures.  I assume that the calcium is simply a precaution.

I'd not worry about it in your case when you're just starting out with meds.  By the time you'd have to worry about it you'll undoubtedly be on some brand new med years from now.

[leximancer]

Here's a follow-up on this topic.  I visited my doctor today and asked him about Viread.  He said that exercise in general and high impact activities specifically would in fact work to counteract the thinning process of bones.  In fact, he said he'd recommend I continue exercising, were I to start Viread.

Also, I collected my first bottles of HAART meds today.  Reyataz, Norvir, and Epzicom.  I start on the 5th.