Bone health and chronic viral infections: A narrative literature review

, liver disease). It has been reported that HBV/HCV co-infection in people living with HIV produces the most severe phenotype through additive inflammatory, hepatic, and metabolic insults. Further, an increased risk of developing osteonecrosis of multiple joints has also been reported among people living with HIV. Given the limited contemporary data, future studies should focus on investigating hierarchical alterations in bone structure to deepen our understanding of the complex skeletal changes in patients with chronic viral infections, thereby providing a solid foundation for advancing clinical management. As the population living with chronic viral infections ages, total joint arthroplasty will increasingly become a standard procedure, requiring a deeper understanding of how various hierarchical bone morpho-structural changes affect implant stability and longevity in these patients.