1. Effect of HIV infection on growth and bone density in peripubertal children in the era of antiretroviral therapy: a cross-sectional study in Zimbabwe
- Author
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Cynthia Mukwasi-Kahari, Rashida A. Ferrand, Kate A Ward, Farirayi Kowo-Nyakoko, Hilda Mujuru, Suzanne Filteau, Ruramayi Rukuni, Victoria Simms, Joseph Chipanga, Celia L Gregson, Grace McHugh, Tafadzwa Madanhire, and Andrea M. Rehman
- Subjects
Male ,Pediatrics ,Bone density ,Cross-sectional study ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Fractures, Bone ,Absorptiometry, Photon ,0302 clinical medicine ,Bone Density ,Hygiene ,Informed consent ,Developmental and Educational Psychology ,030212 general & internal medicine ,Child ,media_common ,Bone mineral ,stunting ,bone density ,Articles ,Institutional review board ,Anti-Retroviral Agents ,Cohort ,Bone mineral content ,Female ,Zimbabwe ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,antiretroviral therapy ,03 medical and health sciences ,children ,030225 pediatrics ,medicine ,Humans ,media_common.cataloged_instance ,European union ,Tenofovir ,business.industry ,Puberty ,HIV ,Antiretroviral therapy ,Cross-Sectional Studies ,Tropical medicine ,Pediatrics, Perinatology and Child Health ,Africa ,Lean body mass ,tenofovir disoproxil fumarate ,business ,Demography ,Biomedical sciences - Abstract
Background: Poor linear growth and pubertal delay, both common in children with HIV (CWH) in sub-Saharan Africa, may affect adolescent bone accrual and future fragility fracture risk. We investigated the association of HIV with size-adjusted bone density in peri-pubertal children in Zimbabwe. Methods: CWH aged 8-16 years taking ART for ≥2 years from public-sector HIV clinics in Harare, and HIV-uninfected children from schools in the same catchment area, were recruited into a cross-sectional study. Sociodemographic, clinical and anthropometric data were collected. Outcomes were dual-energy X-ray absorptiometry (DXA) measured total-body less-head bone mineral content-for-lean mass adjusted for height (TBLH-BMCLBM) and lumbar spine bone mineral apparent density (LS-BMAD). Linear regression models using multiple imputation for missing data, assessed relationships between risk factors and DXA measures by HIV status, and interaction by sex and pubertal (Tanner) stage. Findings: We recruited 303 CWH and 306 without HIV, mean (SD) age 12.5 (2.5) years and 50% female. Mean ART duration was 7.9 (2.6) years; for 34% ART included tenofovir disproxil fumarate (TDF). The prevalence of low TBLH-BMCLBM and LS-BMAD (Z-Score
- Published
- 2021
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