Altered bone metabolism in children infected with human immunodeficiency virus.
OBJECTIVE
Data on bone homoeostasis of children infected with human immunodeficiency virus (HIV), at the time of the gain in bone mass, are very rare. To determine possible alterations in bone metabolism, 13 prepubertal vertically HIV-infected children were studied.


METHODS
Viral load, CD4 count, interleukin-6 (IL-6), growth hormone, insulin-like growth factor-I (IGF-I), IGF binding protein-3 (IGFBP-3), acid-labile subunit (ALS), IGFBP-3 proteolysis, osteocalcin in blood and N-terminal telopeptide of type I collagen in urine were determined. Lumbar spine bone mineral density was examined by dual-energy X-ray absorptiometry.


RESULTS
Low osteocalcin levels were found in all patients. Low IGF-I was found in only six children, who had low CD4 count and high IL-6 levels, with normal levels of IGFBP-3 and ALS, absent IGFBP-3 proteolysis and decreased bone mineral density, irrespective of viral load or growth.


CONCLUSIONS
Low serum osteocalcin levels appear to be an initial warning sign of possible altered bone metabolism in HIV-infected children. However, only when the immune system becomes more seriously compromised is bone loss measurable by bone densitometry.
Zamboni
G
G
Pediatric Clinic, University of Verona, Verona, Italy. Giorgio.Zamboni@univr.it
Antoniazzi
F
F
Bertoldo
F
F
Lauriola
S
S
Antozzi
L
L
Tatò
L
L
D015502:Absorptiometry, Photon / Q000379:methods; D015519:Bone Density / Q000502:physiology*; D001847:Bone Diseases / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism*; D001842:Bone and Bones / Q000378:metabolism*; D015704:CD4 Antigens / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003094:Collagen / Q000652:urine; D024042:Collagen Type I; D005260:Female; D006679:HIV Seropositivity / Q000150:complications* / Q000276:immunology / Q000378:metabolism*; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D015850:Interleukin-6 / Q000276:immunology; D008161:Lumbosacral Region / Q000000981:diagnostic imaging; D008297:Male; D015675:Osteocalcin / Q000097:blood; D010447:Peptide Hydrolases / Q000378:metabolism; D010455:Peptides / Q000652:urine; D012720:Severity of Illness Index
D015704:CD4 Antigens; D024042:Collagen Type I; D018972:Insulin-Like Growth Factor Binding Protein 3; D015850:Interleukin-6; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D003094:Collagen; D010447:Peptide Hydrolases