Dimeglio, Linda A.Wang, JiaJiaSiberry, George K.Miller, Tracie L.Geffner, Mitchell E.Hazra, RohanBorkowsky, WilliamChen, Janet S.Dooley, LauriePatel, KunjalVan Dyke, Russell B.Fielding, Roger A.Gurmu, YaredJacobson, Denise L.Pediatric HIV/AIDS Cohort Study2025-06-202025-06-202013DiMeglio LA, Wang J, Siberry GK, et al. Bone mineral density in children and adolescents with perinatal HIV infection. AIDS. 2013;27(2):211-220. doi:10.1097/QAD.0b013e32835a9b80https://hdl.handle.net/1805/48888Objective: To estimate prevalence of low bone mineral density (BMD) in perinatally HIV-infected (HIV+) and HIV-exposed but uninfected (HEU) children, and to determine predictors of BMD in HIV+. Design: Cross-sectional analysis within a 15-site United States and Puerto Rico cohort study. Methods: Total body and lumbar spine BMD were measured using dual energy-X-ray absorptiometry. BMD Z-scores accounted for bone age and sex. Multiple linear regression was used to evaluate differences in Z-scores by HIV status and for predictors of BMD in HIV+. Results: 350 HIV+ and 160 HEU were enrolled. Mean age was 12.6 and 10.7 years for HIV+ and HEU, respectively. Most (87%) HIV+ were receiving HAART. More HIV+ than HEU had total body and lumbar spine Z-scores less than -2.0 (total body: 7 vs. 1%, P = 0.008; lumbar spine: 4 vs. 1%, P = 0.08). Average differences in Z-scores between HIV+ and HEU were attenuated after height and/or weight adjustment. Among HIV+, total body Z-scores were lower in those with higher CD4% and in those who ever used boosted protease inhibitors or lamivudine. Lumbar spine Z-scores were lower with higher peak viral load and CD4%, more years on HAART, and ever use of indinavir. Conclusion: Rates of low BMD in HIV+ children were greater than expected based on normal population distributions. These differences were partially explained by delays in growth. As most HIV+ children in this study had not entered their pubertal growth spurt, prepubertal factors associated with BMD, magnified or carried forward, may result in sub-optimal peak BMD in adulthood.en-USPublisher PolicyAnti-retroviral agentsBone ageBone mineral densityHIVChildrenCD4Viral loadArticle