Decreased bone turnover in HIV-infected children on antiretroviral therapy.
Decreased bone turnover in HIV-infected children on antiretroviral therapy.
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DOI：
10.1007/s11657-018-0452-6
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发表时间：
2018-04-05
影响因子：
3
通讯作者：
Arpadi SM
中科院分区：
文献类型：
--
作者：
Shiau S;Yin MT;Strehlau R;Patel F;Mbete N;Kuhn L;Coovadia A;Arpadi SM
在这项研究中，我们评估了南非病毒抑制的HIV感染儿童和HIV未感染儿童的免疫激活、骨转换和骨量之间的关系。我们发现，骨量减少可能发生或持续独立于免疫激活和改变骨转换。感染艾滋病毒的儿童和青少年有骨骼生长缺陷，包括骨量减少和骨微结构改变。然而，艾滋病毒感染损害儿童和青少年骨增长的机制尚不清楚。本研究的目的是评估一组青春期前HIV感染儿童的免疫激活、骨转换和骨量之间的关系，这些儿童随机分为两组，一组继续接受利托那韦增强的洛匹那韦（LPV/r）为基础的抗逆转录病毒治疗（ART），另一组转为接受依法韦仑为基础的ART。这项横断面分析包括219名HIV感染和180名HIV未感染的儿童，他们参加了在南非约翰内斯堡进行的CHANGES骨研究。通过双能X线吸收测定法评估全身（WB）骨矿物质含量（BMC），并生成针对性别、年龄和身高调整的WB BMC Z评分。分析骨转换标志物，包括I型胶原C端肽（CTx）和I型前胶原N端前肽（P1 NP）。还测量了免疫活化标志物，包括细胞因子IL-6和TNF-α，以及可溶性CD 14和高敏C反应蛋白（CRP）。与未感染的对照组相比，HIV感染儿童的WB BMC Z评分较低，IL-6和TNF-α相似，可溶性CD 14和高敏CRP较高，骨吸收（CTX）和骨形成（P1 NP）标志物较低。骨转换标志物在那些仍在LPV/r或转换为依法韦仑的患者中没有差异。我们的研究结果表明，在病毒抑制的HIV感染儿童中，骨生成减少可能会发生或持续存在，与免疫激活和骨转换改变无关。
In this study, we evaluated the relationships between immune activation, bone turnover, and bone mass in virally suppressed HIV-infected children and HIV-uninfected children in South Africa. We found that decreased bone mass may occur or persist independent of immune activation and altered bone turnover. HIV-infected children and adolescents have deficits in skeletal growth which include decreases in bone mass and alterations in bone microarchitecture. However, the mechanism by which HIV infection compromises bone accrual in children and adolescents is unclear. The goal of this study was to evaluate the relationships between immune activation, bone turnover, and bone mass in a group of pre-pubertal HIV-infected children randomized to remain on ritonavir-boosted lopinavir (LPV/r)-based antiretroviral therapy (ART) or switch to efavirenz-based ART in South Africa virally suppressed at the time of this study. This cross-sectional analysis included 219 HIV-infected and 180 HIV-uninfected children enrolled in the CHANGES Bone Study conducted in Johannesburg, South Africa. Whole body (WB) bone mineral content (BMC) was assessed by dual x-ray absorptiometry and WB BMC Z-scores adjusted for sex, age, and height were generated. Bone turnover markers, including C-telopeptide of type 1 collagen (CTx) and procollagen type I N-terminal propeptide (P1NP), were analyzed. Markers of immune activation were also measured, including cytokines IL-6 and TNF-alpha, as well as soluble CD14 and high-sensitivity C-reactive protein (CRP). Compared to uninfected controls, HIV-infected children had lower WB BMC Z-scores, similar IL-6 and TNF-alpha, higher soluble CD14 and high-sensitivity CRP, and lower markers of bone resorption (CTX) and bone formation (P1NP). Bone turnover markers were not different in those remaining on LPV/r or switched to efavirenz. Our findings suggest that in HIV-infected children with viral suppression, decreased bone accrual may occur or persist independent of immune activation and altered bone turnover.
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影响因子：
7.4
作者：
Gazzola L;Bellistri GM;Tincati C;Ierardi V;Savoldi A;Del Sole A;Tagliabue L;d'Arminio Monforte A;Marchetti G
通讯作者：
Marchetti G
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120.7
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影响因子：
5.6
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Ichimura H