Impaired Bone Architecture in Peripubertal Children With HIV, Despite Treatment With Antiretroviral Therapy: A Cross-Sectional Study From Zimbabwe
Authors' conclusion
Despite long-term ART, we identified deficits in predicted bone strength in those living with HIV, which were more overt in the later stages of puberty.
Study context
- Population
- Children aged 8 to 16 years in Zimbabwe; 50% female; median age at antiretroviral therapy (ART) initiation 4 (IQR 2–7) years, median ART duration 8 (IQR 6–10) years
- Participants
- 303 vs 306
- Exposure
- Children with HIV on ART vs children without HIV
- CWHn = 303
- Children without HIV (CWOH)n = 306reference
- Outcome
- Tibial peripheral quantitative computed tomography (pQCT): 4% trabecular and 38% cortical vBMD, 4% and 38% CSA, 38% SSI
Methodological detailsfrequency-matched for age strata and sex
- Frequency-matched for age strata and sex
Main finding
As reported in the abstract
Bone architecture by HIV status, later puberty
- Both male and female CWH in later puberty had lower trabecular volumetric bone mineral density (vBMD), cross-sectional area (CSA) (4% and 38%) and stress-strain index (SSI) than CWOH; cortical density similar
- After adjustment, deficits in bone size persisted in CWH in later puberty; puberty worsened the inverse association between HIV and SSI
- CWH vs CWOH: HIV*puberty interaction p = 0.035
- CWH vs CWOH: P = 0.029
- CWH vs CWOH: interaction p = 0.008
- CWH vs CWOH: interaction p = 0.004
- Multivariable linear regression stratified by sex and puberty, adjusted
Observational data: associations, not effects.
Further findings
Prepubertal (Tanner 1)
Stunted (height-for-age Z-score <−2)
Original publication
Impaired Bone Architecture in Peripubertal Children With HIV, Despite Treatment With Antiretroviral Therapy: A Cross-Sectional Study From Zimbabwe. J Bone Miner Res. Published 25 November 2022. doi:10.
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