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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #142736
Title: BONE MINERAL CONTENT IN GIRLS PERINATALLY INFECTED WITH HIV

Author
item O'BRIEN, KIMBERLY - JOHNS HOPKINS UNIV CTR
item RAZAVI, MARYAM - JOHNS HOPKINS UNIV CTR
item HENDERSON, ROBIN - JOHNS HOPKINS UNIV CTR
item CABALLERO, BENJAMIN - JOHNS HOPKINS UNIV CTR
item Ellis, Kenneth

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/14/2000
Publication Date: 4/1/2001
Citation: O'Brien,K.O., Razavi,M., Henderson,R.A., Caballero,B., Ellis,K.J. 2001. Bone mineral content in girls perinatally infected with HIV. American Journal of Clinical Nutrition. 73(4):821-826.

Interpretive Summary: With the advent of new therapies, patients with HIV-infection are living longer. However, few studies have examined the impact of HIV infection on bone growth of children. We examined hormone and vitamin D levels, dietary calcium intake and urinary lost, and bone mineral status of 19 young girls (6-15 years old) who were perinatally infected with HIV. About 1 in 4 had elevated vitamin D levels, while 1 in 7 had elevated parathyroid levels and elevated urinary calcium levels. Bone mineral content was significantly low compared with healthy age-matched children. Young girls with HIV infection have low bone mass and evidence of suboptimal calcium intake. Nutritional counseling of the children (and parents) should emphasize the need for adequate calcium in the diet.

Technical Abstract: Early diagnostic efforts and advances in multidrug therapy have considerably prolonged the survival time of children infected perinatally with HIV. Despite these advances, few studies have addressed calcium status and bone growth in HIV-infected children. Objective: Our objective was to examine the effect of HIV infection on calcium status and bone growth in children. We measured calcitropic hormones, urinary calcium excretion, bine mineral content, and body composition in 19 young girls aged 9.2 +/- 2.6 y (range: 5.9-15.2 y) who were infected perinatally with HIV. Serum concentrations of 1,25-dihydroxyvitamin D [1,25(OH)2D] and parathyroid hormone concentrations were elevated above normal ranges in 25% and 12% of these girls, respectively. Urinary calcium excretion normalized for creatinine excretion was also elevated (Ca/Cr>0.18) in 17% of these children despite suboptimal calcium intakes (679 +/- 437 mg/d). Total-body bone mineral content, measured with the use of dual-energy X-ray absorptiometry, averaged 845.1 +/- 279.0 g and was on average 2.7 z scores below age- and race-matched values reported in non-HIV-infected healthy girls. Significant positive correlations were found between an indirect marker of bone resorption in urine (N-telopeptide) and 1,25(OH)2D (P<0.02, r2 = 0.586, n=9), and between serum N-telopeptide and total alkaline phosphatase (P<0.001, r2 = 0.541, n=17) suggesting that calcium insufficiency may be increasing bone resorption in this group. Young girls with HIV infection had low bone mass and evidence of calcium insufficiency. Nutritional counseling of children with HIV infection should emphasize adequate calcium intakes because of the importance of this age period in bone mineral acquisition.