TY - JOUR T1 - Bone mineral density and vitamin D concentration: the challenges in taking care of children and adolescents infected with HIV JO - The Brazilian Journal of Infectious Diseases T2 - AU - Carmo,Fabiana Bononi AU - Terreri,Maria Teresa AU - Succi,Regina Célia de Menezes AU - Beltrão,Suenia Vasconcelos AU - Gouvea,Aida de Fátima Tomé Barbosa AU - Paulino,Erica Regina Cruz AU - Machado,Daisy Maria SN - 14138670 M3 - 10.1016/j.bjid.2017.03.005 DO - 10.1016/j.bjid.2017.03.005 UR - https://www.bjid.org.br/en-bone-mineral-density-vitamin-d-articulo-S1413867016301465 AB - BackgroundThe increase in life expectancy for patients living with human immunodeficiency virus (HIV) infection has resulted in health complications related to a chronic disease. ObjectivesTo 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. MethodsA 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. Results58 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 23.43ng/mL±2.015 and in T1 22.1ng/mL±0.707 and considered insufficient levels for this population. ConclusionPatients 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. ER -