Bone mineral density and vitamin D concentration: the challenges in taking care of children and adolescents infected with HIV
| Autor: | Erica Regina Cruz Paulino, Suenia Vasconcelos Beltrão, Fabiana Bononi do Carmo, Maria Teresa Terreri, Daisy Maria Machado, Regina Célia de Menezes Succi, Aída F.T.B. Gouvêa |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male Adolescent Human immunodeficiency virus (HIV) lcsh:QR1-502 HIV Infections medicine.disease_cause lcsh:Microbiology lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine Absorptiometry Photon Bone Density Diagnosis medicine Vitamin D and neurology Prevalence Humans lcsh:RC109-216 030212 general & internal medicine Prospective Studies Vitamin D Child Bone Bone mineral business.industry HIV Infant Viral Load 030112 virology CD4 Lymphocyte Count Antiretroviral Infectious Diseases Chronic disease Metabolism Immunology Life expectancy Calcium Female business |
| Zdroj: | Brazilian Journal of Infectious Diseases v.21 n.3 2017 Brazilian Journal of Infectious Diseases Brazilian Society of Infectious Diseases (BSID) instacron:BSID Brazilian Journal of Infectious Diseases, Volume: 21, Issue: 3, Pages: 270-275, Published: JUN 2017 Brazilian Journal of Infectious Diseases, Vol 21, Iss 3, Pp 270-275 (2017) |
| Popis: | Background: The increase in life expectancy for patients living with human immunodeficiency virus (HIV) infection has resulted in health complications related to a chronic disease. Objectives: To evaluate the prevalence of bone mineral density (BMD) alterations and vitamin D concentrations in HIV-infected children and adolescents and to verify the variations in those parameters during a 12-month interval. Methods: A prospective cohort study with a dual period of evaluation was conducted in 57 patients perinatally HIV-infected and one patient with sexual abuse in early infancy. Demographic, anthropometric, pubertal stage, viral load, T CD4+ cell count and antiretroviral therapy were evaluated. Biochemical tests and total body (TB) and lumbar spine (L1–L4) bone density evaluations by dual X-ray absorptiometry (DXA) were performed. Calcium or vitamin D supplements were prescribed if reduction in BMD or deficiency for vitamin D was detected. Results: 58 patients (ages 5.4–18.3 years; 60.3% girls) were included (T0); 55 patients were reevaluated after 12 (±3) months (T1). Low bone mass for chronological age was found in 6/58 (10.4%) and 6/55(10.9%) patients at T0 and at T1, respectively. There was no statistical relationship between z-scores for BMD (BMD z-score) and the variables sex, fracture history, family history of osteoporosis, physical activity and pubertal stage. There was a relation between BMD z-score alterations for TB and HIV viral load at T1 (p = 0.016). There was no association between duration or classes of antiretroviral therapy and bone density. The mean value of vitamin D in T0 was 23.43 ng/mL ± 2.015 and in T1 22.1 ng/mL ± 0.707 and considered insufficient levels for this population. Conclusion: Patients infected with HIV are at risk for BMD alterations and lower vitamin D serum concentrations; both of these variables should be evaluated at routine examinations in order to improve both prevention and therapeutic planning. Keywords: HIV, Antiretroviral, Infant, Diagnosis, Metabolism, Bone |
| Databáze: | OpenAIRE |
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