Bone mineral density and vitamin D concentration: the challenges in taking care of children and adolescents infected with HIV

Bone mineral density and vitamin D concentration: the challenges in taking care of children and adolescents infected with HIV

Author Carmo, Fabiana Bononi Autor UNIFESP Google Scholar
Terreri, Maria Teresa Autor UNIFESP Google Scholar
de Menezes Succi, Regina Celia Autor UNIFESP Google Scholar
Beltrao, Suenia Vasconcelos Autor UNIFESP Google Scholar
Tome Barbosa Gouvea, Aida de Fatima Autor UNIFESP Google Scholar
Cruz Paulino, Erica Regina Autor UNIFESP Google Scholar
Machado, Daisy Maria Autor UNIFESP Google Scholar
Abstract Background: The increase in life expectancy for patients living with human immunodeficiency virus (HIV) infection has resulted in health complications related to a chronic disease. Objectives: To evaluate the prevalence of bone mineral density (BMD) alterations and vitamin D concentrations in HIV-infected children and adolescents and to verify the variations in those parameters during a 12-month interval. Methods: A prospective cohort study with a dual period of evaluation was conducted in 57 patients perinatally HIV-infected and one patient with sexual abuse in early infancy. Demographic, anthropometric, pubertal stage, viral load, T CD4+ cell count and antiretroviral therapy were evaluated. Biochemical tests and total body (TB) and lumbar spine (L1-L4) bone density evaluations by dual X-ray absorptiometry (DXA) were performed. Calcium or vitamin D supplements were prescribed if reduction in BMD or deficiency for vitamin D was detected. Results: 58 patients (ages 5.4-18.3 years

60.3% girls) were included (T0)

55 patients were reevaluated after 12 (+/- 3) months (T1). Low bone mass for chronological age was found in 6/58 (10.4%) and 6/55(10.9%) patients at T0 and at T1, respectively. There was no statistical relationship between z-scores for BMD (BMD z-score) and the variables sex, fracture history, family history of osteoporosis, physical activity and pubertal stage. There was a relation between BMD z-score alterations for TB and HIV viral load at T1 (p = 0.016). There was no association between duration or classes of antiretroviral therapy and bone density. Themean value of vitamin D in T0 was 23.43 ng/mL +/- 2.015 and in T1 22.1ng/mL +/- 0.707 and considered insufficient levels for this population. Conclusion: Patients infected with HIV are at risk for BMD alterations and lower vitamin D serum concentrations

both of these variables should be evaluated at routine examinations in order to improve both prevention and therapeutic planning. (C) 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda.
Keywords HIV
Antiretroviral
Infant
Diagnosis
Metabolism
Bonea
xmlui.dri2xhtml.METS-1.0.item-coverage Rio De Janeiro
Language English
Sponsor Fundacao de Auxilio a Pesquisa do Estado de Sao Paulo
Grant number FAPESP: 2011/20882-2
Date 2017
Published in Brazilian Journal Of Infectious Diseases. Rio De Janeiro, v. 21, n. 3, p. 270-275, 2017.
ISSN 1413-8670 (Sherpa/Romeo, impact factor)
Publisher Elsevier Brazil
Extent 270-275
Origin http://dx.doi.org/10.1016/j.bjid.2017.03.005
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000404453600009
URI https://repositorio.unifesp.br/handle/11600/54538

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