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Bone mineral loss through increased bone turnover in HIV-infected children treated with highly active antiretroviral

S Mora1, N Sala, D Bricalli

  • 1Laboratory of Pediatric Endocrinology, Department of Pediatrics, Scientific Institute H. S. Raffaele, Italy.

AIDS (London, England)
|October 2, 2001
PubMed

Insights

Highly active antiretroviral therapy (HAART) is linked to decreased bone mineral density (BMD) in children with HIV. This bone loss may be a lifelong risk, potentially worsened by lipodystrophy.

Area of Science:

  • Pediatric Endocrinology
  • Infectious Diseases
  • Bone Metabolism

Background:

  • Osteopenia is a concern in children with HIV.
  • The impact of highly active antiretroviral therapy (HAART) on bone health in pediatric HIV is not fully understood.
  • Understanding the etiology of osteopenia in this population is crucial for long-term management.

Purpose of the Study:

  • To evaluate the occurrence of osteopenia in children receiving HAART.
  • To define the aetiology of osteopenia in HIV-infected children on HAART.
  • To assess the relationship between HAART, lipodystrophy, and bone mineral density (BMD).

Main Methods:

  • Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry in 40 vertically HIV-infected children (35 on HAART, 5 untreated).
  • Bone turnover markers (PINP, BALP, NTx) were analyzed.
  • Results were compared to 314 healthy controls, with adjustments for confounding variables.

Main Results:

  • Children on HAART exhibited significantly lower spine and total body BMD compared to both untreated HIV-infected children and healthy controls.
  • HAART-treated children with lipodystrophy showed the lowest total body BMD.
  • Bone turnover markers (BALP, PINP, NTx) were elevated in HAART-treated children, indicating increased bone remodeling.

Conclusions:

  • HAART may represent a novel risk factor for lifelong osteoporosis in children.
  • Increased bone turnover contributes to the observed decrease in BMD.
  • The severity of osteopenia in children on HAART appears correlated with the presence of lipodystrophy.
Abstract

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