Impaired Bone Architecture in Peripubertal Children With HIV, Despite Treatment With Antiretroviral Therapy: A Cross-Sectional Study From Zimbabwe.
Impaired Bone Architecture in Peripubertal Children With HIV, Despite Treatment With Antiretroviral Therapy: A Cross-Sectional Study From Zimbabwe.
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DOI：
10.1002/jbmr.4752
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发表时间：
2023-03
影响因子：
6.2
通讯作者：
Gregson, Celia L.
中科院分区：
文献类型：
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作者：
Mukwasi-Kahari, Cynthia;Rehman, Andrea M.;Breasail, Micheal O.;Rukuni, Ruramayi;Madanhire, Tafadzwa;Chipanga, Joseph;Stranix-Chibanda, Lynda;Micklesfield, Lisa K.;Ferrand, Rashida A.;Ward, Kate A.;Gregson, Celia L.
艾滋病毒感染对儿童有多系统的不利影响，包括对生长中的骨骼。我们的目的是确定慢性HIV感染和骨结构（密度，大小，强度）在青春期儿童之间的关联。我们对接受抗逆转录病毒治疗（ART）的8-16岁艾滋病毒感染儿童（CWH）和从学校招募的无艾滋病毒儿童（CWOH）进行了横断面研究，频率与年龄层和性别相匹配。通过胫骨外周定量计算机断层扫描（pQCT）测量的结局包括4%小梁和38%皮质体积骨矿物质密度（vBMD）、4%和38%横截面积（CSA）和38%应力应变指数（SSI）。多变量线性回归测试艾滋病毒状态和结果之间的关联，按性别和青春期分层（坦纳1-2 vs. 3-5），调整年龄，身高，脂肪量，体力活动，社会经济和成年状态。我们招募了303名CWH和306名CWOH; 50%为女性。虽然CWH与CWOH的年龄相似（总体平均值±SD 12.4± 2.5岁），但青春期前的患者更多（即坦纳1; 41% vs. 23%）。ART开始时的中位年龄为4（IQR 2-7）岁，而ART的中位持续时间为8（IQR 6-10）年。CWH比那些没有艾滋病毒的人更经常发育不良（身高-年龄Z分数<-2）（33%比7%）。青春期后期的男性和女性CWH的骨小梁vBMD、CSA（4%和38%）和SSI均低于无HIV的患者，而皮质密度相似。调整解释了其中的一些差异;然而，在青春期后期，CWH的骨大小缺陷持续存在（HIV* 青春期相互作用p=0.035[男性; 4%CSA]和p=0.029[女性; 38%CSA]）。同样，青春期进一步恶化艾滋病毒和骨强度（SSI）之间的负相关性在男性（交互作用p=0.008）和女性（交互作用p=0.004）。尽管有长期的ART，我们发现HIV感染者的预测骨强度存在缺陷，这在青春期后期更为明显。这是令人担忧的，因为这可能会转化为以后生活中更高的骨折风险。
HIV infection has multi-system adverse effects in children including on the growing skeleton. We aimed to determine the association between chronic HIV infection and bone architecture (density, size, strength) in peripubertal children. We conducted a cross-sectional study of children aged 8–16 years with HIV (CWH) on antiretroviral therapy (ART), and children without HIV (CWOH) recruited from schools, frequency matched for age strata and sex. Outcomes, measured by tibial peripheral Quantitative Computed Tomography (pQCT), included 4% trabecular and 38% cortical volumetric bone mineral density (vBMD), 4% and 38% cross-sectional area (CSA), and 38% stress-strain index (SSI). Multivariable linear regression tested associations between HIV status and outcomes, stratified by sex and puberty (Tanner 1–2 vs. 3–5), adjusting for age, height, fat mass, physical activity, socio-economic and orphanhood statuses. We recruited 303 CWH and 306 CWOH; 50% female. Whilst CWH were similar in age to CWOH (overall mean±SD 12.4±2.5years), more were pre-pubertal (i.e Tanner 1; 41% vs. 23%). Median age at ART initiation was four (IQR 2–7) years, whilst median ART duration was eight (IQR 6–10) years. CWH were more often stunted (height-for-age Z-score<−2), than those without HIV (33% vs 7%). Both male and female CWH in later puberty had lower trabecular vBMD, CSA (4% and 38%) and SSI than those without HIV, whilst cortical density was similar. Adjustment explained some of these differences; however, deficits in bone size persisted in CWH in later puberty (HIV*puberty interaction p=0.035[males; 4% CSA] and p=0.029[females; 38% CSA]). Similarly, puberty further worsened the inverse association between HIV and bone strength (SSI) in both males (interaction p=0.008) and females (interaction p=0.004). Despite long-term ART, we identified deficits in predicted bone strength in those living with HIV, which were more overt in the later stages of puberty. This is concerning as this may translate to higher fracture risk later in life.
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影响因子：
4
作者：
Hamill, M. M.;Ward, K. A.;Pettifor, J. M.;Norris, S. A.;Prentice, A.
通讯作者：
Prentice, A.
影响因子：
2.5
作者：
Jain, Rajesh K.;Vokes, Tamara
通讯作者：
Vokes, Tamara
影响因子：
4
作者：
Hernandez, CJ;Beaupré, GS;Carter, DR
通讯作者：
Carter, DR
DOI：
10.1177/2325957414531621
发表时间：
2014-11-01
影响因子：
--
作者：
Joel, Dipesalema R;Mabikwa, Vincent;Ahmed, Syed Faisal
通讯作者：
Ahmed, Syed Faisal
影响因子：
4.1
作者：
Gregson, Celia L.;Hartley, April;Ferrand, Rashida A.
通讯作者：
Ferrand, Rashida A.