Factors associated with low bone mineral density in a Brazilian cohort of vertically HIV-infected adolescents

Annie Schtscherbyna, Maria Fernanda Miguens Castelar Pinheiro, Laura Maria Carvalho de Mendonça, Carla Gouveia, Ronir Raggio Luiz, Elizabeth Stankiewicz Machado, Maria Lucia Fleiuss de Farias
2012 International Journal of Infectious Diseases  
Objective: To assess the prevalence and factors associated with low bone mineral density (BMD) in HIVinfected adolescents. Methods: This was a cross-sectional study of a Brazilian cohort of vertically HIV-infected adolescents. Body composition and lumbar spine (LS) and total body (TB) BMD were estimated by dual-energy X-ray absorptiometry (DXA). Low BMD was considered for a Z-score À2 standard deviations. Pubertal development, anthropometric data, laboratory measurements, antiretroviral
more » ... iretroviral regimen, and time of immunological and virological recovery were evaluated as factors associated with a low BMD. Results: Seventy-four adolescents aged 17.3 AE 1.8 years were studied. Low BMD was present in 32.4% of them. LS and TB BMD Z-scores were positively correlated with weight, body mass index (BMI), BMI Z-score, total body fat, and nutritional status. Patients on tenofovir had lower LS and TB BMD Z-scores. Time on tenofovir was indirectly correlated with LS and TB BMD Z-scores. No difference was found regarding levels of calcium, parathyroid hormone, or 25-hydroxyvitamin D according to BMD status. Conclusions: Control of the HIV infection, especially before the initiation of puberty, might have a positive influence on bone gain. Body composition and nutritional status had a positive influence on BMD that was more evident in females, suggesting that nutritional intervention may have a positive impact on BMD. ß
doi:10.1016/j.ijid.2012.07.019 pmid:23031418 fatcat:zutwyv7rjfdglo6rd64wptwrxu