Alendronate for Prevention of AntiRetroviral Therapy-associated Bone Loss

Inclusion Criteria: * male\>30 years old or female\>35 years old * HIV-1 antibody positive * antiretroviral therapy naïve * be presumed to have achieved peak bone mass * be eligible for initiation of antiretroviral therapy in the opinion of the investigator * be able to provide written, informed consent Exclusion Criteria: * subjects unable to comply with the study protocol or unable to stand/sit upright for at least 30 minutes * history of osteoporosis * history of fragility fracture or previous femoral fracture * chronic renal failure * hypocalcemia or hypercalcemia at screening * history of Paget's disease or known primary hyperparathyroidism * previous treatment with or allergy (including hypersensitivity) to bisphosphonates * recent history (past 12 months) of peptic or duodenal ulcers or oesophagitis, aspiration or any other abnormality of the oesophagus * current therapy with prescribed calcium or vitamin D preparations (other than over-the-counter multivitamin preparations) * current therapy with aspirin or other regularly prescribed non-steroidal anti-inflammatory drugs * recent dental work (within the past 3 months) or poor oral hygiene (as judged in the opinion of the investigator) * recent (within the past three months) significant steroid exposure * for female subjects: pregnancy at screening, planning future pregnancies or unwilling to take measures to avoid pregnancy for the duration of the study * where in the investigator's opinion, there is a necessity to initiate ART within the pre-ART study window period * hepatitis B or hepatitis C co-infection * any active illness (including AIDS illness) which in the opinion of the investigator precludes participation in the study * subjects concurrently enrolled in another clinical trial of an investigational medical product