Abstract: The extended survival time of HIV-infected persons leads to longer exposures both to the virus itself and to the agents used for ART. Osteoporosis/osteopenia in HIV-infected patients were reported by numerous authors. Their pathomechanism is still not fully understood, however, several studies assessing the skeletal complications in HIV-infected patients have been published in the previous decade, leading to improved understanding of the underlying mechanisms of such events. We summarize the data on the key parameters of calcium and phosphate metabolism, the risk factors of low bone mineral density in HIV-infected population. We discuss possible molecular pathomechanism of bone damage in HIV-infected patients. Additionally, recommendations regarding proper diagnosis and pharmacologic management of HIV osteoporosis are given.