Jacobson, Denise L.Stephensen, Charles B.Miller, Tracie L.Patel, KunjalChen, Janet S.Van Dyke, Russell B.Mirza, AyeshaSchuster, Gertrud U.Hazra, RohanEllis, AngelaBrummel, Sean S.Geffner, Mitchell E.Silio, MargaritaSpector, Stephen A.DiMeglio, Linda A.2019-04-302019-04-302017-09-01Jacobson, D. L., Stephensen, C. B., Miller, T. L., Patel, K., Chen, J. S., Van Dyke, R. B., … Pediatric HIV/AIDS Cohort Study (2017). Associations of Low Vitamin D and Elevated Parathyroid Hormone Concentrations With Bone Mineral Density in Perinatally HIV-Infected Children. Journal of acquired immune deficiency syndromes (1999), 76(1), 33–42. doi:10.1097/QAI.0000000000001467https://hdl.handle.net/1805/19047BACKGROUND: Perinatally HIV-infected (PHIV) children have, on average, lower bone mineral density (BMD) than perinatally HIV-exposed uninfected (PHEU) and healthy children. Low 25-hydroxy vitamin D [25(OH)D] and elevated parathyroid hormone (PTH) concentrations may lead to suboptimal bone accrual. METHODS: PHIV and PHEU children in the Pediatric HIV/AIDS Cohort Study had total body (TB) and lumbar spine (LS) BMD and bone mineral content (BMC) measured by dual-energy x-ray absorptiometry; BMD z-scores (BMDz) were calculated for age and sex. Low 25(OH)D was defined as ≤20 ng/mL and high PTH as >65 pg/mL. We fit linear regression models to estimate the average adjusted differences in BMD/BMC by 25(OH)D and PTH status and log binomial models to determine adjusted prevalence ratios of low 25(OH)D and high PTH in PHIV relative to PHEU children. RESULTS: PHIV children (n = 412) were older (13.0 vs. 10.8 years) and more often black (76% vs. 64%) than PHEU (n = 207). Among PHIV, children with low 25(OH)D had lower TB-BMDz [SD, -0.38; 95% confidence interval (CI), -0.60 to -0.16] and TB-BMC (SD, -59.1 g; 95% CI, -108.3 to -9.8); high PTH accompanied by low 25(OH)D was associated with lower TB-BMDz. Among PHEU, children with low 25(OH)D had lower TB-BMDz (SD, -0.34; 95% CI, -0.64 to -0.03). Prevalence of low 25(OH)D was similar by HIV status (adjusted prevalence ratio, 1.00; 95% CI, 0.81 to 1.24). High PTH was 3.17 (95% CI, 1.25 to 8.06) times more likely in PHIV children. CONCLUSIONS: PHIV and PHEU children with low 25(OH)D may have lower BMD. Vitamin D supplementation trials during critical periods of bone accrual are needed.en-USPublisher Policy25-hydroxy-vitamin DParathyroid hormoneHIV infectionChildrenBone mineral densityArticle