Longitudinal Changes of Bone Mineral Density and Metabolism in Antiretroviral-Treated Human Immunodeficiency Virus-Infected Children

• Published in: The journal of clinical endocrinology and metabolism Vol. 89; no. 1; pp. 24 - 28
• Main Authors: Mora, Stefano, Zamproni, Ilaria, Beccio, Sabrina, Bianchi, Roberta, Giacomet, Vania, Viganò, Alessandra
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01.01.2004; Copyright by The Endocrine Society
• Subjects: Absorptiometry, Photon; Adolescent; Adult; Alkaline Phosphatase - blood; Antiretroviral Therapy, Highly Active - adverse effects; Biological and medical sciences; Bone and Bones - enzymology; Bone and Bones - metabolism; Bone Density; Bone Diseases, Metabolic - epidemiology; Bone Diseases, Metabolic - etiology; Bone Remodeling; Bone Resorption; Child; Child, Preschool; Collagen - urine; Collagen Type I; Drug toxicity and drugs side effects treatment; Female; highly active antiretroviral therapy; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - physiopathology; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Longitudinal Studies; Lumbar Vertebrae; Male; Medical sciences; Peptides - urine; Pharmacology. Drug treatments; Toxicity: osteoarticular system; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Human; Immunopathology; Drug combination; HIV-1 virus; Toxicity; Retroviridae; AIDS; Metabolism; Immune deficiency; Lentivirus; Infection; Virus; Chemotherapy; Treatment; Viral disease; Antiviral; Complication; Bone mineral density; Human immunodeficiency virus; Osseous tissue; Child
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2003-030767

Highly active antiretroviral therapy (HAART) may be a contributory factor for a decreased bone mass and altered bone metabolism in HIV-infected children. However, the evolution of bone mineral density (BMD) and bone metabolism during HAART has not been studied yet. In the current longitudinal study we monitored the changes of BMD and bone metabolism over a period of 12 months. Thirty-two HIV-infected children (15 girls and 17 boys), aged from 6.3 to 17.7 yr, with a long duration of HAART exposure (40.0 months at baseline) were enrolled in the study. As a control group, 381 healthy volunteers of comparable age were assessed. BMD was measured at the lumbar spine and whole skeleton by dual-energy x-ray absorptiometry. Bone-specific alkaline phosphatase (BALP, as bone formation index) and N-terminal telopeptide of type I collagen (as bone resorption index) were measured in serum and urine, respectively. BMD values at baseline were significantly lower at all skeletal sites than those of control subjects. The annual increment of spine BMD was comparable to normal, whereas that of the whole skeleton was significantly lower (P < 0.04). BALP and N-terminal telopeptide of type I collagen concentrations were significantly higher compared with controls at baseline and at follow-up. BALP annual changes of HIV patients were significantly different from normal. Our data confirm the presence of low BMD and bone metabolism derangement in HIV-infected children treated with HAART. The role of possible therapeutic approach to restore bone mass and metabolism should be assessed in pediatrics.