Total body and spinal bone mineral density across Tanner stage in perinatally HIV-infected and uninfected children and youth in PACTG 1045.
OBJECTIVE
To characterize total body bone mineral content (BMC) and total body and spinal bone mineral density (BMD) in perinatally HIV-infected and uninfected children/youth across puberty.


METHODS
HIV-infected (7-24 years) were randomly selected from six strata based on Tanner stage/protease inhibitor use. HIV-uninfected were frequency-matched by Tanner group and sociodemographic background to the HIV-infected.


METHODS
Dual-energy X-ray absorptiometry (DXA) measured BMC and BMD. Linear regression models tested differences in bone outcomes by HIV and the interaction of HIV by Tanner group (1-2, 3-4, 5). Models were performed separately by sex and adjusted for DXA scanner, race/ethnicity, height, age and lean body mass.


RESULTS
HIV-infected (N = 236) and uninfected (N = 143) were comparable on sex and race/ethnicity. HIV-infected were slightly older (median 12.6 versus 11.9 years). In adjusted models, HIV-infected males had significantly lower total body BMC and total body and spinal BMD at Tanner 5, lower BMC at Tanner 3-4 and similar BMC and BMD at Tanner 1-2, compared to HIV-uninfected males. HIV-infected and uninfected girls did not differ significantly on any bone outcome, but there was a marginally significant interaction of HIV and Tanner group for spinal BMD. Kaletra/ritonavir was associated with lower BMC and total body BMD and nevirapine was associated with higher spinal BMD in a model with all HIV-infected.


CONCLUSIONS
Perinatally HIV-infected males showed more evidence of lower bone density especially in the final stage of pubertal development than HIV-infected girls and they may be at increased risk for bone disease during adulthood.
Jacobson
Denise L
DL
Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, USA. jacobson@sdac.harvard.edu
Lindsey
Jane C
JC
Gordon
Catherine M
CM
Moye
Jack
J
Hardin
Dana S
DS
Mulligan
Kathleen
K
Aldrovandi
Grace M
GM
D015502:Absorptiometry, Photon; D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D015519:Bone Density / Q000502:physiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D008297:Male; D011627:Puberty / Q000502:physiology*; D011877:Radionuclide Imaging; D012737:Sex Factors; D013131:Spine / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult