[Evaluation of bone mineral density in children with vertical infection by HIV]

Area of Science:

• Pediatric Endocrinology
• Infectious Diseases
• Bone Metabolism

Background:

• Bone mineral density (BMD) changes are prevalent in adults with human immunodeficiency virus (HIV).
• Limited research exists on bone health in children with HIV.
• Evaluating BMD in vertically HIV-infected children is crucial for understanding long-term health implications.

Purpose of the Study:

• To assess bone mineral density (BMD) in children infected with human immunodeficiency virus (HIV) through vertical transmission.
• To identify factors associated with reduced BMD in this pediatric population.

Main Methods:

• A cohort of 53 vertically HIV-infected children aged 8-18 years was studied.
• Data collected included disease status, nutritional assessment, vitamin D (25-OHD) levels, and immunological status.
• Bone mineral density (BMD) was measured using densitometry, with statistical analyses including regression models.

Main Results:

• A significant proportion of children had low vitamin D levels (33.3%) and low BMD (11% hip, 6% spine, 4% whole body).
• BMD was found to correlate with BMI, height, disease stage, and duration of antiretroviral treatment.
• Protease inhibitors (PIs) were the only antiretroviral class that maintained statistical significance in association with BMD after adjustment for other variables.

Conclusions:

• Vertically HIV-infected children exhibit lower bone mineral density (BMD) compared to reference data.
• Disease severity, short stature, low BMI, and prolonged antiretroviral therapy, especially protease inhibitor (PI)-based regimens, are linked to reduced bone mass in pediatric HIV.
• These findings highlight the need for monitoring bone health in children living with HIV.