Altered bone metabolism in children infected with human immunodeficiency virus

• Published in: Acta Paediatrica Vol. 92; no. 1; pp. 12 - 16
• Main Authors: Zamboni, G, Antoniazzi, F, Bertoldo, F, Lauriola, S, Antozzi, L, Tatò, L
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2003; Blackwell
• Subjects: Absorptiometry, Photon - methods; Biological and medical sciences; Bone and Bones - metabolism; Bone densitometry; Bone Density - physiology; Bone Diseases - complications; Bone Diseases - diagnosis; Bone Diseases - metabolism; bone metabolism; CD4 Antigens - immunology; Child; Child, Preschool; children; Collagen - urine; Collagen Type I; Diseases of the osteoarticular system; Female; HIV infection; HIV Seropositivity - complications; HIV Seropositivity - immunology; HIV Seropositivity - metabolism; Human Growth Hormone - metabolism; Human viral diseases; Humans; Infectious diseases; Insulin-Like Growth Factor Binding Protein 3 - metabolism; Insulin-Like Growth Factor I - metabolism; interleukin-6; Interleukin-6 - immunology; Lumbosacral Region - diagnostic imaging; Male; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Osteocalcin - blood; Peptide Hydrolases - metabolism; Peptides - urine; Severity of Illness Index; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Somatotropin hormone; interleukin-6; Interleukin 6; Insulin like growth factor binding protein; Protein hormone; Collagen type I; children; Densitometry; Child; Human; Immunopathology; Osteocalcin; Bone densitometry; Retroviridae; AIDS; Insulin like growth factor 1; Metabolism; Immune deficiency; Lentivirus; Infection; Virus; bone metabolism; Adenohypophyseal hormone; Viral disease; Human immunodeficiency virus; Osseous tissue; HIV infection
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2003.tb00461.x

Aim: Data on bone homoeostasis of children infected with human immunodeficiency virus (HIV), at the time of the gain in bone mass, are very rare. To determine possible alterations in bone metabolism, 13 prepubertal vertically HIV‐infected children were studied. Methods: Viral load, CD4 count, interleukin‐6 (IL‐6), growth hormone, insulin‐like growth factor‐I (IGF‐I), IGF binding protein‐3 (IGFBP‐3), acid‐labile subunit (ALS), IGFBP‐3 proteolysis, osteocalcin in blood and N‐terminal telopeptide of type I collagen in urine were determined. Lumbar spine bone mineral density was examined by dual‐energy X‐ray absorptiometry. Results: Low osteocalcin levels were found in all patients. Low IGF‐I was found in only six children, who had low CD4 count and high IL‐6 levels, with normal levels of IGFBP‐3 and ALS, absent IGFBP‐3 proteolysis and decreased bone mineral density, irrespective of viral load or growth. Conclusion: Low serum osteocalcin levels appear to be an initial warning sign of possible altered bone metabolism in HIV‐infected children. However, only when the immune system becomes more seriously compromised is bone loss measurable by bone densitometry.