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Review
. 2016 May;11(3):294-300.
doi: 10.1097/COH.0000000000000270.

Bone health in HIV-infected children and adolescents

Allison R Eckard  1 , Stefano Mora
Affiliations
Review

Bone health in HIV-infected children and adolescents

Allison R Eckard et al. Curr Opin HIV AIDS. 2016 May.

Abstract

Purpose of review: Chronic HIV infection and exposure to antiretroviral therapy compromises bone health in children and adolescents, potentially impacting their long-term quality of life. Thus, the purpose of this article is to review the most recent literature on this topic in HIV-infected children and adolescents.

Recent findings: Recent studies continue to demonstrate bone abnormalities in HIV-infected children and adolescents, whether HIV is acquired perinatally or during adolescence. Researchers have employed new modalities, both high tech and those that can be utilized in resource-limited settings, to better assess bone health. New data suggest that this population may also be experiencing an increase incidence of fractures, and they may not acquire the same peak bone mass as their HIV-uninfected counterparts. Reassuringly, however, in-utero tenofovir exposure does not appear to have a significant impact on bone health in HIV-exposed, uninfected infants.

Summary: HIV-infected children and adolescents are exposed to HIV and antiretroviral therapy for many decades starting early in life and during the most critical time for skeletal growth and bone mass accrual. Recent findings underscore the need for further research on bone in this population. Longitudinal studies are especially needed to evaluate long-term risk of osteoporosis and fracture.

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Conflict of interest statement

Conflicts of interest

ARE has received research funding from Bristol-Myers Squibb, Cubist Pharmaceuticals, and GlaxoSmithKline and has served as an advisor and speaker for Gilead. SM has no conflicts of interest.

Figures

Figure 1
Figure 1. Timing of the effect of antiretroviral therapy on bone mass and bone metabolism
The available data indicate that the skeletal system of infants is not affected. The negative outcome begins in childhood and worsens with age with the most significant effects during puberty when the majority of bone mass is accumulated. The role of HIV is still unclear, although in vitro studies show a direct effect of the virus on bone cells.
See this image and copyright information in PMC

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