Fractures in children and adolescents living with perinatally acquired HIV.
Fractures in children and adolescents living with perinatally acquired HIV.
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围产期感染艾滋病毒的儿童和青少年的骨折。
DOI：
10.1016/j.bone.2020.115515
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发表时间：
2020
期刊：
影响因子：
4.1
通讯作者：
PediatricHIV/AIDSCohortStudy
中科院分区：
文献类型：
--
作者：
Jacobson,DeniseL;Yu,Wendy;Hazra,Rohan;Brummel,Sean;Geffner,MitchellE;Patel,Kunjal;Borkowsky,William;Wang,Jiajia;Chen,JanetS;Mirza,Ayesha;DiMeglio,LindaA;PediatricHIV/AIDSCohortStudy
在许多情况下，与未感染的同龄人相比，感染围产期获得性艾滋病毒（PHIV）的儿童/青少年的骨密度在年龄和性别上都较低。我们在儿童HIV/AIDS队列研究（PHACS）中评估了PHIV和暴露于HIV的未感染（PHEU）参与者的骨折/长骨骨折发生率和骨质疏松患病率。方法：通过图表回顾和/或访谈获得从出生到20岁的骨折史，包括骨折年龄、机制和骨折部位。泊松回归模型比较了年龄、性别和种族调整后的HIV感染状况对骨折发生率的影响，年龄（<6岁，≥6岁）对骨折发生率的影响有所改变。结果与PHEU儿童/青少年（N= 206）相比，sphiv （N= 412）患者年龄较大（中位数17.5 vs 16.7岁），黑人（72% vs 61%）较多。17%的hiv患者和12%的PHEU患者曾报告过骨折。在<6岁的儿童中，PHIV≥1次骨折的调整发生率比高于PHEU (7.23, 95% CI 0.98, 53.51)，但在≥6岁的儿童/青少年中相似（1.20,95% CI: 0.77, 1.87）。长骨骨折的结果相似。最常见的骨折机制是站立高度摔地（PHIV为23.6%，PHEU为8.8%）和运动损伤（21.3%，PHEU为32.4%），最常见的骨折部位是前臂和手腕/手的小骨。这些孩子都没有骨质疏松症。结论在≥6岁的儿童/青少年中，围生期HIV感染与骨折发生率相似。为了确定PHIV和PHEU成年后的骨折率，有必要对骨折史进行前瞻性、有针对性的收集。收集围产期获得性艾滋病毒（PHIV）感染儿童/青少年和艾滋病毒暴露的未感染儿童（PHEU）从出生到20岁的骨折史。在小于6岁的儿童中，PHIV的骨折发生率高于PHEU，但在较大的儿童/青少年中没有。
BackgroundAcross numerous settings, bone mineral density for age and sex is lower in children/adolescents living with perinatally-acquired HIV (PHIV) compared to uninfected peers. We assessed incidences of any fracture/any long bone fracture, and osteoporosis prevalence in PHIV and HIV-exposed uninfected (PHEU) participants in the Pediatric HIV/AIDS Cohort Study (PHACS).MethodologyLifetime history of fracture events from birth up to age 20 years was obtained by chart review and/or interview, including age at fracture, mechanism, and bone(s) fractured. Poisson regression models were fit comparing fracture incidence by HIV status adjusted for age, sex, and race, with effect modification by age (<6, ≥6 yr).ResultsPHIV (N= 412) were older (median 17.5 vs 16.7 yr) and more frequently reported black race (72% vs 61%) than PHEU children/adolescents (N= 206). 17% of PHIV and 12% of PHEU ever reported a fracture. Among children <6 yr, the adjusted incidence rate ratio of ≥1 fracture was higher (7.23; 95% CI 0.98, 53.51) in PHIV than PHEU, but similar among children/adolescents ≥6 years (1.20; 95% CI: 0.77, 1.87). Results were similar for long bone fracture. The most common fracture mechanisms were falling to the ground from a standing height (23.6% PHIV vs 8.8% PHEU) and sports injuries (21.3% vs 32.4%), and the most commonly fractured sites were the forearm and small bones of the wrist/hands. None of the children had osteoporosis.ConclusionsAmong children/adolescents ≥6 yr of age, fractures were similar by perinatal HIV status. Prospective, targeted collection of fracture history will be necessary to determine rates of fracture as PHIV and PHEU age into adulthood.SummaryLifetime fracture history was collected in children/adolescents living with perinatally-acquired HIV (PHIV) and HIV-exposed uninfected (PHEU) children from birth up to age 20 years. Fracture incidence was higher in PHIV compared to PHEU among children <6 years old, but not among older children/adolescents.
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影响因子：
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作者：
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