Costa C, Scabini S, Kaimal A, et al. - Researchers evaluated calcaneal Quantitative Ultrasound for its predictive value for bone mineral density (BMD) reduction in a population of Ugandan HIV+ individuals on long-term antiretroviral therapy (ART). Further, they examined the prevalence of proximal tubular dysfunction and the relationship among raised urine retinol-binding protein/creatinine ratio (uRBP/uCr) and decreased BMD. In this cross-sectional study, 101 HIV+ adults on continuous ART for ≥ 10 years were included at the Infectious Diseases Institute, Kampala, Uganda. The participants had undergone DXA scan during the previous 12 months. The analysis revealed a significant association of DXA BMD measurements with the calcaneal speed of sound, broadband ultrasound attenuation, and quantitative ultrasound index. Abnormal uRBP/uCr values were observed in 47 individuals (47%). uRBP/uCr was identified to be significantly inversely correlated with DXA T-scores. The high prevalence of subclinical tubular impairment emphasizes expanding access to TDF-sparing regimens in resource-limited settings.