Bone mineral content in girls perinatally infected with HIV.
BACKGROUND
Early diagnostic efforts and advances in multidrug therapy have considerably prolonged the survival time of children infected perinatally with HIV. Despite these advances, few studies have addressed calcium status and bone growth in HIV-infected children.


OBJECTIVE
Our objective was to examine the effect of HIV infection on calcium status and bone growth in children.


METHODS
We measured calcitropic hormones, urinary calcium excretion, bone mineral content, and body composition in 19 young girls aged 9.2 +/- 2.6 y (range: 5.9-15.2 y) who were infected perinatally with HIV.


RESULTS
Serum concentrations of 1,25-dihydroxyvitamin D [1,25(OH)(2)D] and parathyroid hormone concentrations were elevated above normal ranges in 25% and 12% of these girls, respectively. Urinary calcium excretion normalized for creatinine excretion was also elevated (Ca/Cr >0.18) in 17% of these children despite suboptimal calcium intakes (679 +/- 437 mg/d). Total-body bone mineral content, measured with the use of dual-energy X-ray absorptiometry, averaged 845.1 +/- 279.0 g and was on average 2.7 z scores below age- and race-matched values reported in non-HIV-infected healthy girls. Significant positive correlations were found between an indirect marker of bone resorption in urine (N:-telopeptide) and 1,25(OH)2D (P < 0.02, r2 = 0.586, n = 9), and between serum N-telopeptide and total alkaline phosphatase (P < 0.001, r2 = 0.541, n = 17), suggesting that calcium insufficiency may be increasing bone resorption in this group.


CONCLUSIONS
Young girls with HIV infection had low bone mass and evidence of calcium insufficiency. Nutritional counseling of children with HIV infection should emphasize adequate calcium intakes because of the importance of this age period in bone mineral acquisition.
Johns Hopkins University Center for Human Nutrition, School of Hygiene and Public Health, Baltimore, MD 21205-2179, USA. kobrien@jhsph.edu
K O
KO
O'Brien
M
M
Razavi
R A
RA
Henderson
B
B
Caballero
K J
KJ
Ellis
D015502:Absorptiometry, Photon; D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D044383:Black People; D001823:Body Composition; D015519:Bone Density / Q000502:physiology*; D001846:Bone Development; D001862:Bone Resorption; D002117:Calcitriol / Q000097:blood*; D002118:Calcium / Q000032:analysis* / Q000172:deficiency; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D011939:Mental Recall; D010281:Parathyroid Hormone / Q000097:blood*; D018743:Perinatal Care; D044465:White People
D010281:Parathyroid Hormone; D003404:Creatinine; D002117:Calcitriol; D002118:Calcium