Biochemical Markers of Calcium and Bone Metabolism during and after Lactation in Ugandan Women with HIV on Universal Maternal Antiretroviral Therapy
Authors' conclusion
These differences resemble reported TDF effects, especially raised PTH, increased bone resorption, decreased bone formation, and decreased renal function, and may explain the observed differences in bone mineral density and breast milk calcium.
Study context
- Population
- Ugandan pregnant and lactating women with and without HIV; samples at 36 weeks of gestation, 14 and 26 weeks of lactation, and 3–6 months after lactation
- Exposure
- Women with HIV (WWH) on TDF-based ART vs women without HIV
- Outcome
- Biochemical markers of calcium and bone metabolism, WWH vs REF
- Follow-up
- 36 weeks of gestation to 3-6 months after lactation
Main finding
As reported in the abstract
36 weeks of gestation to 3-6 months after lactation
- Higher PTH throughout in WWH
- +31%
- Lower 1,25(OH)2 D throughout in WWH
- −9%
- Lower TmP/GFR throughout in WWH
- −9%
- Lower P1NP in pregnancy in WWH
- −27%
- Lower plasma phosphate in pregnancy in WWH
- −10%
- Higher CTX during and after lactation in WWH
- +15%
- Higher BALP during and after lactation in WWH
- +19%
- Lower eGFR during and after lactation in WWH
- −4%
- Lower P1NP/CTX ratio in WWH in pregnancy
- −21%
- Lower P1NP/CTX ratio in WWH in lactation
- −15%
- Lower plasma calcium in WWH at one or both lactation timepoints
- −5%
- Lower FGF23 in WWH at one or both lactation timepoints
- −16%
- Lower fasting urinary calcium in WWH at one or both lactation timepoints
- −34%
- Higher fasting urinary phosphate in WWH at 26 weeks of lactation and after lactation
- +22%
Observational data: associations, not effects.
Further findings
Vitamin D status (25OHD) · throughout
- Mean 25OHD >50 nmol/L throughout
Original publication
Biochemical Markers of Calcium and Bone Metabolism during and after Lactation in Ugandan Women with HIV on Universal Maternal Antiretroviral Therapy. J Bone Miner Res. Published 24 July 2023. doi:10.
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