Bone mineral density in young patients with perinatal infection with human immunodeficiency virus

The study of the issue of impaired bone mineral density (BMD) in people living with human immunodeficiency virus (HIV) who were infected perinatally (from birth) has objective reasons for the development of osteoporosis (OP). However, information about the state of bone tissue in this group is limited and no studies have been conducted in Russia. The role of risk factors and approaches to diagnosis, treatment, and prevention of osteoporosis have not been determined. Objectives. To assess the state of BMD using densitometry in perinatal HIV-infected adults on antiretroviral therapy (ART). Material and methods. This study included patients with perinatal HIV infection (n = 38) (main group) who continue to be followed up in the adult department of a specialized center and patients with sexually acquired HIV infection (n = 36) (comparison group) who have reached adulthood but are not older than 25 years old. Both groups were not concurrently infected with HIV or HBV. Were analyzed the level of CD4+ lymphocytes and the HIV RNA. Hip and spine densitometry was performed to assess bone matrix status using the Z-score taking into account age group of study participants. Results. Patients with perinatal HIV infection had a disease duration similar to their age at the time of the study, while the duration of ART administration was 13 years with a maximum of 21 years and 5 months. BMI in the study group showed that 73.6% of indicators were within normal limits, 5 patients had low body weight and one had grade I obesity, accounting for 2.6% respectively. Currently, three (7.8%) patients had detectable levels of HIV RNA despite irregular ART intake, with no signifi cant diff erences in CD4 lymphocyte counts during analysis of this indicator. At the time of diagnosis, the proportion of patients with immunodefi ciency was 20.9%. However, at the time of the study, this proportion had increased to 23.2%. Hip and spine densitometry, two patients (5.2%) were identifi ed with signs of osteopenia. The cause of this disorder is multifactorial and includes the presence of HIV infection, duration of antiretroviral therapy, and, in one case, the presence of concurrent somatic pathology requiring constant intake of glucocorticosteroids. Conclusion. Patients with perinatal HIV infection are at risk of developing osteoporosis and require regular medical monitoring to detect bone mineral density (BMD) disorders early and treat them promptly.

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