Changes in peripheral quantitative computed tomography measured bone density, size, and strength in Zimbabwean children with and without HIV over one year: a cohort study
Authors' conclusion
In conclusion, CWH show bone deficits at follow-up.
Study context
- Population
- Zimbabwean children aged 8–16 years; tibial peripheral quantitative computed tomography (pQCT) scans at 0 and 12 months
- Participants
- 609 children
- Exposure
- Children with HIV vs children without HIV
- Outcome
- Change in pQCT bone density (trabecular and cortical), size (total CSA) and strength (SSI)
- Follow-up
- 12 months
Methodological detailssex-stratified analysis, structural equation modeling
- Sex-stratified analysis
- Structural equation modeling
Main finding
As reported in the abstract
Change in pQCT bone density, size and strength, adjusted for SES and orphanhood
CWH vs CWOHMean difference, mm2 (95% CI)P value
∆CSA, males, mid/late puberty; greater increase with CWH
31.3(−3.1 to 65.6)
interaction p-value = 0.013∆CSA, males, pre/early puberty
−2.04(−23.8 to 19.7)
interaction p-value = 0.013Observational data: associations, not effects.
Further findings
Bone measures at baseline and follow-up
- Children with HIV (CWH) had lower trabecular density, CSA and SSI than children without HIV (CWOH)
Mediation by baseline HAZ of HIV effect on ∆bone outcomes (females only)
- Indirect pathway HIV to ∆trabecular density
- −2.47 (−4.4, −0.5) mg/cm³
- Indirect pathway HIV to ∆cortical density
- −3.26 (−5.5, −0.9) mg/cm³
- Indirect pathway HIV to ∆SSI
- −15.76 (−27.3, −4.2) mm³
- HAZ mediated the effect only in females
Baseline characteristics
- Orphans, CWH vs CWOH
- 44% vs 7%
- Lower socio-economic status (SES), CWH vs CWOH
- 43% vs 27%
- Stunted, CWH vs CWOH
- 30% vs 8%
- Similar in age
Original publication
Changes in peripheral quantitative computed tomography measured bone density, size, and strength in Zimbabwean children with and without HIV over one year: a cohort study. J Bone Miner Res. Published 16 October 2024. doi:10.
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