PMID- 32141960
OWN - NLM
STAT- MEDLINE
DCOM- 20201106
LR  - 20220202
IS  - 1944-7884 (Electronic)
IS  - 1525-4135 (Print)
IS  - 1525-4135 (Linking)
VI  - 84
IP  - 1
DP  - 2020 May 1
TI  - Deficits in Bone Architecture and Strength in Children Living With HIV on 
      Antiretroviral Therapy.
PG  - 101-106
LID - 10.1097/QAI.0000000000002309 [doi]
AB  - BACKGROUND: Reduced bone mineral mass by dual x-ray absorptiometry is reported in 
      children living with HIV (CLWH), but few studies of bone microarchitecture, 
      particularly in sub-Saharan Africa, have been conducted. Here, we compare bone 
      architecture and strength in black South African CLWH and uninfected control 
      children by peripheral quantitative computed tomography (pQCT). SETTING AND 
      METHODS: One hundred seventy-two CLWH on antiretroviral therapy (ART) and 98 
      controls in the CHANGES Bone Study in Johannesburg, South Africa received pQCT 
      scans of the radius and tibia. Measurements included trabecular and cortical 
      volumetric bone mineral density (vBMD) and bone strength, estimated by the polar 
      strength strain index (SSI), a validated measure of fracture risk. RESULTS: CLWH 
      (51% boys) and controls (63% boys) were an average of age 10.4 years. Mean ART 
      duration for CLWH was 9.5 years, with 70.9% on an efavirenz-based, 28.5% on a 
      lopinavir/ritonavir-based, and 1 child on an atazanavir/ritonavir-based regimen. 
      Male CLWH had lower trabecular vBMD at the radius than controls after adjustment 
      for age, radial length, and Tanner stage (beta = -17.3, standard error = 7.2, P = 
      0.018). Bone strength by polar SSI was lower in CLWH than controls (778 vs. 972 
      mm, P < 0.01). CLWH on an LPV/r-based regimen had lower trabecular vBMD (199 vs. 
      222 mg/cm, P < 0.001) and cortical vBMD (1074 vs. 1093 mg/cm, P = 0.004) than 
      those on an efavirenz-based regimen. No difference in bone strength by polar SSI 
      was observed between treatment groups. CONCLUSION: CLWH initiated on ART early in 
      life with well-controlled HIV have deficits in bone architecture and reductions 
      in bone strength as detected by pQCT.
FAU - Shiau, Stephanie
AU  - Shiau S
AD  - Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 
      Piscataway, NJ.
FAU - Yin, Michael T
AU  - Yin MT
AD  - Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia 
      University Irving Medical Center, New York, NY.
FAU - Strehlau, Renate
AU  - Strehlau R
AD  - Empilweni Services and Research Unit, Department of Pediatrics and Child Health, 
      Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of 
      the Witwatersrand, Johannesburg, South Africa.
FAU - Burke, Megan
AU  - Burke M
AD  - Empilweni Services and Research Unit, Department of Pediatrics and Child Health, 
      Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of 
      the Witwatersrand, Johannesburg, South Africa.
FAU - Patel, Faeezah
AU  - Patel F
AD  - Empilweni Services and Research Unit, Department of Pediatrics and Child Health, 
      Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of 
      the Witwatersrand, Johannesburg, South Africa.
FAU - Kuhn, Louise
AU  - Kuhn L
AD  - SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), G.H. 
      Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia 
      University Irving Medical Center, New York, NY.
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University 
      Irving Medical Center, New York, NY.
FAU - Coovadia, Ashraf
AU  - Coovadia A
AD  - Empilweni Services and Research Unit, Department of Pediatrics and Child Health, 
      Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of 
      the Witwatersrand, Johannesburg, South Africa.
FAU - Norris, Shane A
AU  - Norris SA
AD  - SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health 
      Sciences, University of the Witwatersrand, Johannesburg, South Africa; and.
FAU - Arpadi, Stephen M
AU  - Arpadi SM
AD  - Empilweni Services and Research Unit, Department of Pediatrics and Child Health, 
      Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of 
      the Witwatersrand, Johannesburg, South Africa.
AD  - SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), G.H. 
      Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia 
      University Irving Medical Center, New York, NY.
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University 
      Irving Medical Center, New York, NY.
AD  - Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia 
      University Irving Medical Center, New York, NY.
CN  - Changes Bone Study Team
LA  - eng
GR  - R01 HD073952/HD/NICHD NIH HHS/United States
GR  - R01 HD073977/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Anti-HIV Agents/*therapeutic use
MH  - *Bone Density
MH  - Bone and Bones/diagnostic imaging/*pathology/physiopathology
MH  - Case-Control Studies
MH  - Child
MH  - Female
MH  - HIV Infections/*drug therapy/*pathology/physiopathology
MH  - Humans
MH  - Male
MH  - Tomography, X-Ray Computed
PMC - PMC8805126
MID - NIHMS1771692
EDAT- 2020/03/07 06:00
MHDA- 2020/11/11 06:00
PMCR- 2022/02/01
CRDT- 2020/03/07 06:00
PHST- 2020/03/07 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2020/03/07 06:00 [entrez]
PHST- 2022/02/01 00:00 [pmc-release]
AID - 00126334-202005010-00016 [pii]
AID - 10.1097/QAI.0000000000002309 [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2020 May 1;84(1):101-106. doi: 
      10.1097/QAI.0000000000002309.