{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:51:39Z","timestamp":1777895499945,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Bone fragility in people living with HIV (PLWH) reflects both reduced bone mineral density (BMD) and impaired microarchitecture, while functional decline may further amplify fracture vulnerability. This study evaluated whether adding a pragmatic sarcopenia screen improves bone fragility characterization beyond DXA-BMD, trabecular bone score (TBS), calcaneal quantitative ultrasound (QUS), and biomarkers, and explored the relationship between tenofovir disoproxil fumarate (TDF) exposure and microarchitectural impairment. Materials and Methods: In this single-center cross-sectional study at Victor Babe\u0219 University of Medicine and Pharmacy Timi\u0219oara, 98 adults on stable ART underwent DXA (T-scores), lumbar TBS (reported as TBS \u00d7 100), calcaneal QUS (SOS\/BUA), and bone turnover markers (CTX, P1NP, 25(OH)D). Sarcopenia screening used handgrip strength and 4 m gait speed. Associations were tested using group comparisons, correlations, and multivariable modeling for degraded TBS (TBS \u00d7 100 &lt; 124.0). Results: Sarcopenia screen-positive participants (n = 28) had lower TBS (123.8 vs. 127.7, p = 0.02), lower lumbar T-score (\u22121.7 vs. \u22121.2, p = 0.014), lower SOS (1523.3 vs. 1548.8 m\/s, p = 0.002), and higher CTX (0.6 vs. 0.4 ng\/mL, p &lt; 0.001), with less frequent viral suppression (60.7% vs. 85.7%, p = 0.006). With &gt;5 years TDF exposure (n = 28), degraded TBS prevalence was 82.1% vs. 40.0% in never-exposed (p = 0.001), alongside lower TBS (123.1 vs. 129.8, p &lt; 0.001) and higher CTX (0.6 vs. 0.4 ng\/mL, p &lt; 0.001). Viral suppression independently reduced odds of degraded TBS (aOR 0.3, 95% CI 0.1\u20130.9; p = 0.034). Conclusions: In PLWH, prolonged TDF exposure and functional impairment co-occur with worse densitometric and microarchitectural profiles; viral suppression shows an independent protective association with microarchitecture.<\/jats:p>","DOI":"10.3390\/medicina62030603","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:07:06Z","timestamp":1774271226000},"page":"603","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Multimodal Bone Fragility Profiling in People Living with HIV: Trabecular Bone Score, Calcaneal Quantitative Ultrasound, and Sarcopenia Screening"],"prefix":"10.3390","volume":"62","author":[{"given":"David Vladut","family":"Razvan","sequence":"first","affiliation":[{"name":"Doctoral School, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Jenel Marian","family":"Patrascu","sequence":"additional","affiliation":[{"name":"Orthopaedics II Research Center, \u201cPius Brinzeu\u201d Emergency County Hospital, 300723 Timisoara, Romania"},{"name":"Department of Orthopedics and Traumatology, Victor Babes University of Medicine and Pharmacy, Efimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8236-2205","authenticated-orcid":false,"given":"Ovidiu","family":"Rosca","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iulia Georgiana","family":"Bogdan","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livia","family":"Stanga","sequence":"additional","affiliation":[{"name":"Discipline of Microbiology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1824-2628","authenticated-orcid":false,"given":"Adrian","family":"Vlad","sequence":"additional","affiliation":[{"name":"Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Internal Medicine II, Division of Diabetes, Nutrition and Metabolic Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camelia Vidita","family":"Gurban","sequence":"additional","affiliation":[{"name":"Department IV Biochemistry and Pharmacology, Discipline of Biochemistry, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Schinas, G., Schinas, I., Ntampanlis, G., Polyzou, E., Gogos, C., and Akinosoglou, K. 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