Prospective studies of extensive p samples are needed, to elucidate the epidemiology, pathogenesis, clinical issues, and evolution of HIV-associated bone metabolism abnormalities. When planning strategies for their early diagnosis, prevention, and management, also cost-effectiveness issues should be taken into consideration, since no pharmacoeconomic data still exist in this setting. Although severe consequences (pathological fractures, prosthetic implants), are expected to be proportionally infrequent events, their consequences in terms of length-intensity of hospitalization, related costs, and especially consequences on the patient's quality of life, are expected to play a remarkable role. Anyway, the most reliable diagnostic procedure of O (i.e. DEXA scan), has affordable costs (around Eur 43.40 for a scan which also offers a body composition assessment), as well as the first-line drugs for osteopenia, e.g. supplementation with calcium (Eur 6/month), and vitamin D (Eur 7/month). These costs cannot be compared with the standards costs of an asymptomatic cART-treated p (Eur 471 to 874/month), and the immunologic, virologic, laboratory, and clinical controls made at least quarterly in the same p.