Background: The success of highly active antiretroviral therapy (HAART) has dramatically increased life expectancy for human immunodeficiency virus (HIV)-positive patients, revealing a range of chronic problems associated with HIV. Among others, low bone mineral density (BMD) has been described in HIV-infected youths. Little is currently known about the changes of BMD over time in these patients.
Objective and hypotheses: The aim of the study was to assess BMD changes over a ten-year period in a large cohort of HIV-infected young patients and to compare the results to the data obtained on a healthy control group of children and adolescents.
Method: We report the 10 year follow-up data of 26 patients (13 girls), on HAART containing tenofovir disoproxyl fumarate (TDF). The age at entry of the study ranged from 5 to 17 years. BMD measurements were compared to those obtained in 201 healthy subjects (325 years). BMD was measured at the lumbar spine (L1L4 vertebrae) and in the whole skeleton. Analysis of the data were performed nonlinear mixed effect regression models for longitudinal data for both patients and controls.
Results: HIV-infected patients did not differ from controls subjects in anthropometric measurements. Comparisons between the curves of healthy controls and HIV-infected patients showed significant differences at lumbar spine (P<.0001) and in the whole skeleton (P<.01) in boys and girls. However, further analyses showed that the difference between patients and controls did not change over time.
Conclusion: Our long-term follow-up of BMD measurements demonstrate that the initial deficit in BMD does not worsen over time in patients receiving HAART. Moreover, the use of TDF appears to be safe as opposed to adult patients with HIV infection.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology