[Frontiers in Bioscience E2, 1265-1274, June 1, 2010]

Pediatric HIV infection and bone health: an emerging challenge

Stefano Mora1, Ilaria Zamproni1, Gianvincenzo Zuccotti2, Alessandra Vigano2

1Stefano Mora, and Ilaria Zamproni, Laboratory of Pediatric Endocrinology and BoNetwork, Division of Metabolic and Cardiovascular Sciences, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy, 2Alessandra Vigano, Pediatric Infectivology Unit, Department of Pediatrics, L. Sacco Hospital, via G.B. Grassi 74, 20157 Milan, Italy

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. Pediatric bone health
4. Non-invasive bone mass measurements in children
4.1. Dual-energy x-ray absorptiometry
4.2. Quantitative computed tomography
4.3. Quantitative ultrasonography
5. Bone metabolism in children
6. Bone mass and metabolism in HIV-infected children
6.1. Bone mineral measurement
6.2. Bone metabolism
6.3. Pathogenesis of skeletal health impairment
7. Therapeutic intervention for HIV-related osteopathy
8. Perspective
9. References

1. ABSTRACT

The available data indicate that HIV-infected children and adolescents have reduced bone mass compared to healthy peers. The increased survival due to the control of HIV infection by potent antiretroviral treatment, exposes patients to the achievement of a reduced peak bone mass and to an increased fracture risk during adult life. Reduced bone mass in HIV-infected children is the result of altered bone metabolism, showing significantly increased bone resorption rate. Both infection per se and the use of certain antiretroviral compounds seem to contribute to the altered metabolism. Preventative measures to improve bone health are thus necessary in all young patients that exhibit low bone mass measurements and altered bone metabolism.