Bone mineral density in children and adolescents with perinatal HIV infection

Linda A. DiMeglio, Jiajia Wang, George K. Siberry, Tracie L Miller, Mitchell E. Geffner, Rohan Hazra, William Borkowsky, Janet S. Chen, Laurie Dooley, Kunjal Patel, Russell B. Van Dyke, Roger A. Fielding, Yared Gurmu, Denise L. Jacobson

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

OBJECTIVE: To estimate prevalence of low bone mineral density (BMD) in perinatally HIV-infected (HIV+) and HIV-exposed but uninfected (HEU) children, and to determine predictors of BMD in HIV+. DESIGN: Cross-sectional analysis within a 15-site United States and Puerto Rico cohort study. METHODS: Total body and lumbar spine BMD were measured using dual energy-X-ray absorptiometry. BMD Z-scores accounted for bone age and sex. Multiple linear regression was used to evaluate differences in Z-scores by HIV status and for predictors of BMD in HIV+. RESULTS: 350 HIV+ and 160 HEU were enrolled. Mean age was 12.6 and 10.7 years for HIV+ and HEU, respectively. Most (87%) HIV+ were receiving HAART. More HIV+ than HEU had total body and lumbar spine Z-scores less than -2.0 (total body: 7 vs. 1%, P=0.008; lumbar spine: 4 vs. 1%, P=0.08). Average differences in Z-scores between HIV+ and HEU were attenuated after height and/or weight adjustment. Among HIV+, total body Z-scores were lower in those with higher CD4% and in those who ever used boosted protease inhibitors or lamivudine. Lumbar spine Z-scores were lower with higher peak viral load and CD4%, more years on HAART, and ever use of indinavir. CONCLUSION: Rates of low BMD in HIV+ children were greater than expected based on normal population distributions. These differences were partially explained by delays in growth. As most HIV+ children in this study had not entered their pubertal growth spurt, prepubertal factors associated with BMD, magnified or carried forward, may result in sub-optimal peak BMD in adulthood.

Original languageEnglish
Pages (from-to)211-220
Number of pages10
JournalAIDS
Volume27
Issue number2
DOIs
StatePublished - Jan 14 2013

Fingerprint

Bone Density
HIV Infections
HIV
Spine
Highly Active Antiretroviral Therapy
Indinavir
Puerto Rico
Lamivudine
Normal Distribution
Photon Absorptiometry
Growth
Protease Inhibitors
Viral Load
Linear Models

Keywords

  • antiretroviral agents
  • bone age
  • bone mineral density
  • CD4
  • children
  • HIV
  • viral load

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

DiMeglio, L. A., Wang, J., Siberry, G. K., Miller, T. L., Geffner, M. E., Hazra, R., ... Jacobson, D. L. (2013). Bone mineral density in children and adolescents with perinatal HIV infection. AIDS, 27(2), 211-220. https://doi.org/10.1097/QAD.0b013e32835a9b80

Bone mineral density in children and adolescents with perinatal HIV infection. / DiMeglio, Linda A.; Wang, Jiajia; Siberry, George K.; Miller, Tracie L; Geffner, Mitchell E.; Hazra, Rohan; Borkowsky, William; Chen, Janet S.; Dooley, Laurie; Patel, Kunjal; Van Dyke, Russell B.; Fielding, Roger A.; Gurmu, Yared; Jacobson, Denise L.

In: AIDS, Vol. 27, No. 2, 14.01.2013, p. 211-220.

Research output: Contribution to journalArticle

DiMeglio, LA, Wang, J, Siberry, GK, Miller, TL, Geffner, ME, Hazra, R, Borkowsky, W, Chen, JS, Dooley, L, Patel, K, Van Dyke, RB, Fielding, RA, Gurmu, Y & Jacobson, DL 2013, 'Bone mineral density in children and adolescents with perinatal HIV infection', AIDS, vol. 27, no. 2, pp. 211-220. https://doi.org/10.1097/QAD.0b013e32835a9b80
DiMeglio LA, Wang J, Siberry GK, Miller TL, Geffner ME, Hazra R et al. Bone mineral density in children and adolescents with perinatal HIV infection. AIDS. 2013 Jan 14;27(2):211-220. https://doi.org/10.1097/QAD.0b013e32835a9b80
DiMeglio, Linda A. ; Wang, Jiajia ; Siberry, George K. ; Miller, Tracie L ; Geffner, Mitchell E. ; Hazra, Rohan ; Borkowsky, William ; Chen, Janet S. ; Dooley, Laurie ; Patel, Kunjal ; Van Dyke, Russell B. ; Fielding, Roger A. ; Gurmu, Yared ; Jacobson, Denise L. / Bone mineral density in children and adolescents with perinatal HIV infection. In: AIDS. 2013 ; Vol. 27, No. 2. pp. 211-220.
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