Aseptic osteonecrosis of the jaw in a patient with HIV on tenofovir

The introduction of antiretroviral therapy has improved survival of people with HIV (PWH). However, morbidities that accompany aging and the added burden of antiretroviral therapy on bone metabolism are growing concerns with treatment and improved survival. While a few studies have been done among PWH examining bone density and risk of fractures, the association with osteonecrosis is less studied. PWH have been reported to have osteonecrosis involving the hip joint, shoulder joint, knees, and ankles. Most cases of osteonecrosis associated with HIV infection involve the femoral head, but the involvement of the jaw is rare. We report a case of osteonecrosis of the jaw in a patient who has had HIV for more than 10 years.