Bone mineral density among children living with HIV failing first-line anti-retroviral therapy in Uganda: A sub-study of the CHAPAS-4 trial

Eva Natukunda, Alex Szubert, Caroline Otike, Imerida Namyalo, Esther Nambi, Alasdair Bamford, Katja Doerholt, Diana M Gibb, Victor Musiime and Phillipa Musoke

PLOS ONE, 2023, vol. 18, issue 7, 1-11

Abstract: Background: Children living with perinatally acquired HIV (CLWH) survive into adulthood on antiretroviral therapy (ART). HIV, ART, and malnutrition can all lead to low bone mineral density (BMD). Few studies have described bone health among CLWH in Sub-Saharan Africa. We determined the prevalence and factors associated with low BMD among CLWH switching to second-line ART in the CHAPAS-4 trial (ISRCTN22964075) in Uganda. Methods: BMD was determined using dual-energy X-ray Absorptiometry (DXA). BMD Z-scores were adjusted for age, sex, height and race. Demographic characteristics were summarized using median interquartile range (IQR) for continuous variables and proportions for categorical variables. Logistic regression was used to determine the associations between each variable and low BMD. Results: A total of 159 children were enrolled (50% male) with median age (IQR) 10 (7–12) years, median duration of first -line ART 5.2(3.3–6.8) years; CD4 count 774 (528–1083) cells/mm3, weight—for–age Z-score -1.36 (-2.19, -0.65) and body mass index Z-score (BMIZ) -1.31 (-2.06, -0.6). Low (Z-score≤ -2) total body less head (TBLH) BMD was observed in 28 (18%) children, 21(13%) had low lumbar spine (LS) BMD, and15 (9%) had both. Low TBLH BMD was associated with increasing age (adjusted odds ratio [aOR] 1.37; 95% CI: 1.13–1.65, p = 0.001), female sex (aOR: 3.8; 95% CL: 1.31–10.81, p = 0.014), low BMI (aOR 0.36:95% CI: 0.21–0.61, p

Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0288877

DOI: 10.1371/journal.pone.0288877

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