Bone mineral density and vitamin D concentration: the challenges in taking care of children and adolescents infected with HIV

Carmo, Fabiana Bononi do; Terreri, Maria Teresa; Succi, Regina Célia de Menezes; Beltrão, Suênia Vasconcelos; Gouvea, Aida de Fátima Tomé Barbosa; Paulino, E.R.C.; Machado, Daisy Maria

doi:10.1016/j.bjid.2017.03.005

Cited by 6 publications

(8 citation statements)

References 26 publications

(28 reference statements)

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“…They also agree that adequate ingestion and serum micronutrient monitoring can prevent disorders in bone metabolism and benefit children or adolescents who already have some type of impairment in this tissue 8,13,14 . Although Lima et al 7 found no significant relationship between low BMD and calcium intake.…”

Section: Resultsmentioning

confidence: 88%

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Effects of HAART in the nutritional status of children and adolescents infected by HIV in Brazil: a systematic review

Gratão

Nascimento

2021

Ciênc. saúde coletiva

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The verification of factors associated with growth, body composition and nutritional and nutritional aspects after HIV infection in children or adolescents in Brazil is fundamental for progress in this area. We selected articles published until 2018, available on the platforms PubMed and Lilacs, using the keywords The following descriptors and their associations were used, extracted from MeSH: “Children”, “Adolescent”, “Anthropometry”, “Nutritional Assessment”, “HIV”, “Brazil” adding the filter “and” for advanced searches. A total of 1,450 articles were found, and after selection and full reading, 19 were selected. The studies agreed that children and adolescents living with HIV present or may present alterations in bone metabolism, lipid metabolism and body composition due to infection or associated with therapy. Significant differences were observed in weight and height in infected infants compared to uninfected infants. The evaluation and monitoring of diet quality, as well as serum micronutrient monitoring, are fundamental to guarantee the clinical and treatment conditions of these patients, as well as to prevent disorders due to low nutrient intakes.

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Section: Resultsmentioning

confidence: 88%

“…All the articles selected for the theme (1) 7,8,13,14 (Chart 1) agreed that children who lives with HIV present or may present alterations in bone metabolism, whether due to infection or associated with HAART.…”

Section: Resultsmentioning

confidence: 99%

Effects of HAART in the nutritional status of children and adolescents infected by HIV in Brazil: a systematic review

Gratão

Nascimento

2021

Ciênc. saúde coletiva

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“…Several studies have reported low bone mineral density (BMD) with increased risk of osteoporosis, osteopenia and, osteomalacia in HIV-infected individuals, including men, women, younger and older patients and vertically infected children [ 7 - 16 ]. A recent study evaluating 58 HIV-infected children and adolescents between the ages of 5.3 to 18.3 years, including 63.3% girls found an increased risk for lower BMD and lower levels of vitamin D serum concentration [ 17 ] and the loss in BMD is associated with the levels of vitamin D binding protein [ 18 ]. These and other studies [ 19 ] suggest that vitamin D levels should be included in the overall evaluation of HIV-infected patients.…”

Section: Hiv Infection and Bone Mineral Densitymentioning

confidence: 99%

HIV Infection and Bone Abnormalities

Ahmad

2017

TOORTHJ

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More than 36 million people are living with human immunodeficiency virus (HIV) infection worldwide and 50% of them have access to antiretroviral therapy (ART). While recent advances in HIV therapy have reduced the viral load, restored CD4 T cell counts and decreased opportunistic infections, several bone-related abnormalities such as low bone mineral density (BMD), osteoporosis, osteopenia, osteomalacia and fractures have emerged in HIV-infected individuals. Of all classes of antiretroviral agents, HIV protease inhibitors used in ART combination showed a higher frequency of osteopenia, osteoporosis and low BMD in HIV-infected patients. Although the mechanisms of HIV and/or ART associated bone abnormalities are not known, it is believed that the damage is caused by a complex interaction of T lymphocytes with osteoclasts and osteoblasts, likely influenced by both HIV and ART. In addition, infection of osteoclasts and bone marrow stromal cells by HIV, including HIV Gp120 induced apoptosis of osteoblasts and release of proinflammatory cytokines have been implicated in impairment of bone development and maturation. Several of the newer antiretroviral agents currently used in ART combination, including the widely used tenofovir in different formulations show relative adverse effects on BMD. In this context, switching the HIV-regimen from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) showed improvement in BMD of HIV-infected patients. In addition, inclusion of integrase inhibitor in ART combination is associated with improved BMD in patients. Furthermore, supplementation of vitamin D and calcium with the initiation of ART may mitigate bone loss. Therefore, levels of vitamin D and calcium should be part of the evaluation of HIV-infected patients.

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“…CBD risk is increased in perinatally-acquired HIV independent of traditional CBD risk factors [46–49**], possibly leading to premature osteoporosis and fractures.…”

Section: Introductionmentioning

confidence: 99%

“…Low phosphate in turn stimulates parathyroid hormone release [53]. Although this should increase vitamin D hydroxylation and activation, TDF interferes with vitamin D activation in the kidney, further stimulating secondary hyperparathyroidism [46, 48, 54]. Excessive parathyroid hormone activity inappropriately increases osteoclast and decreases osteoblast differentiation resulting in increased bone resorption and reduced formation of new bone matrix.…”

Section: Introductionmentioning

confidence: 99%

Noncommunicable diseases in adolescents with perinatally acquired HIV-1 infection in high-income and low-income settings

Innes

Patel

2018

Current Opinion in HIV and AIDS

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Bone mineral density and vitamin D concentration: the challenges in taking care of children and adolescents infected with HIV

Abstract: 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.

Cited by 6 publications

References 26 publications

Effects of HAART in the nutritional status of children and adolescents infected by HIV in Brazil: a systematic review

Effects of HAART in the nutritional status of children and adolescents infected by HIV in Brazil: a systematic review

HIV Infection and Bone Abnormalities

Noncommunicable diseases in adolescents with perinatally acquired HIV-1 infection in high-income and low-income settings

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