Bone Abstracts

Objectives: There are conflicting data on the skeletal health of patients with perinatal HIV. We aimed to evaluate the bone profile of a paediatric population followed in a reference centre for perinatal HIV.

Methods: The following data were recorded: dietary calcium intake, extra-curricular exercise, fracture history, medications and comorbidities. All patients were assessed for growth and skeletal deformities. They underwent laboratory tests:CD4 count, CD4/CD8, HIV viral load and basic bone profile, including 25(OH)D and PTH. Finally, they had a DXA scan (GE Lunar Prodigy, paediatric software) for evaluation of bone mineral density (BMD) of L1-L4 and total body less head (TBLH), bone dimensions and strength, as well as fat mass (FM) and lean tissue mass (LTM). For calculation of Z-scores and statistical comparisons, 57 age- and sex-matched controls were used.

Results: Fourteen patients were studied, aged 9.9±4.2 years (6 boys, 8 girls). They were on lopinavir/ritonavir, zidovudine and lamivudine. 50% of the patients had regular exercise. Only one post-traumatic fracture was reported; one patient had mild scoliosis and three patients complained of bone pain. Z-scores for height, weight, BMI, FM and LTM, as well as BMD, bone dimensions and strength were all comparable to controls. Their laboratory tests were also unremarkable, although 50% of the patients reported inadequate calcium intake. BMI Z-score was strongly and positively correlated to Z-scores for muscle and fat mass (r=0.578 and 0.566, respectively, P=0.03). Finally, only two patients had very low CD4 (<500/ml); their BMD at both sites and bone strength (bone mineral content/LTM ratio) were lower (P=0.02), compared to the other patients.

Conclusion: In our cohort, who were promptly diagnosed, treated and carefully followed through the years, growth, skeletal health and body composition were not compromised. CD4 count may have a prognostic value in detecting those patients in need of a more comprehensive bone health evaluation.

Disclosure: The authors declared no competing interests.