Hoy JF, et al. - In HIV-positive adults with low bone mass, researchers assessed the effects of switching tenofovir disoproxil fumarate (TDF) or treatment with an intravenous bisphosphonate on bone mineral density (BMD). They performed a 2-year, randomized, open-label study at 10 sites in Australia and Spain analyzing 112 adults on TDF-based antiretroviral therapy (ART). Among these, 87 adults with low BMD (T-score < −1.0 at hip or spine by dual-energy X-ray absorptiometry) and undetectable plasma HIV viral load were randomized to either switch TDF to another active antiretroviral drug or to continue TDF-based ART and receive intravenous zoledronic acid (ZOL) 5 mg annually for 2 years. For increasing BMD in HIV-positive adults with low bone mass outcomes support the higher efficacy of providing ZOL vs switching TDF.