Effect of HIV infection on growth and bone density in peripubertal children in the era of antiretroviral therapy: a cross-sectional study in Zimbabwe
Ruramayi Rukuni, Andrea M. Rehman, Cynthia Mukwasi-Kahari, Tafadzwa Madanhire, Farirayi Kowo-Nyakoko, Grace McHugh, Suzanne Filteau, Joseph Chipanga, Victoria Simms, Hilda Mujuru, Kate A. Ward, Rashida A. Ferrand, Celia L. Gregson
Abstract
BACKGROUND: Faltered linear growth and pubertal delay, which are both common in children with HIV in sub-Saharan Africa, might affect adolescent bone accrual and future fragility fracture risk. We investigated the association of HIV with bone density adjusted for skeletal size in peripubertal children in Zimbabwe. METHODS: and LS-BMAD Z-scores in children with and without HIV. FINDINGS: Z-score of 0·41 (95% CI 0·08-0·74; p=0·015) and in LS-BMAD Z-score of 0·31 (0·08-0·69; p=0·12). INTERPRETATION: Despite ART, HIV is associated with substantial skeletal deficits towards the end of puberty. The extent of bone deficits associated with TDF and its widespread use in children in sub-Saharan Africa are a concern for future adult fracture risk. FUNDING: Wellcome Trust.