Abstract LB8 - Decreases in Total Body Bone Mineral Content Progress with Age in HIV-infected Children

LB8 Decreases in Total Body Bone Mineral Content Progress with Age in HIV-infected Children

S. Arpadi*, M. Horlick, J. Thornton, P. Cuff, J. Wang, S. Quezada, and D. Kotler.
St.Luke's-Roosevelt Hosp. Ctr., Columbia Univ., New York, NY

Background:Bone abnormalities have been reported in association with HIV-infection in adults, but bone mineral status has not been evaluated in children. The study objective was to evaluate the total body bone mineral content (TBBMC) in a cohort of perinatally HIV-infected children.

Method:A cross-sectional study measuring TBBMC by DXA (Lunar DPX, pediatric software version 3.8g, Lunar Corp, Madison, WI) was performed in 51 prepubertal HIV-infected children ages 4.2-14.7 y and 282 healthy prepubertal children of similar age and racial/ethnic background. Multiple variable regression modeling was used to assess differences in log TBBMC between HIV-infected (HIV+) and healthy (HIV-) children. Additional covariates included age, weight, height, bone area, gender and race/ethnicity.

Results:The mean age of the entire study group was 8.4±1.8y (4.2-14.7 y) and included 174(52%) males and 159(48%) females. The mean CD4 count among HIV-infected children was 465±419/cc3. Twenty-three HIV-infected children were receiving a PI-containing regimen, 6 were on NNRTI-containing regimens, 22 received RTI only, and 3 were on no ARV at the time of study. Significant reductions in log TBBMC, which progressed with age (HIV/age interaction, p=0.032), were observed. The negative effect of HIV status on TBBMC (p <0.0001) persisted after adjustment for body size, race/ethnicity, gender, and bone area. No associations were observed between TBBMC and PI treatment, CD4 count, or CD4%.

Conclusions:Decreases in TBBMC were observed in HIV-infected children. The differential in TBBMC was specifically associated with HIV status and progressed with age, possibly indicating that duration of infection is an important variable. The abnormality in TBBMC was independent of PI treatment and could not be accounted for by the smaller body size of HIV-infected children.