Table 4.

Prevalence of low bone mineral density among HIV-infected children and adolescents

Reference	Population	Duration of ART (years)	Findings	Associated factors
DiMeglio [29]	N=350 Mean age 12.6 years Black 66%, Hispanic 26% and white 8%	9.5 years (IQR 9.1–11.3) 25% had CDC C Nadir CD4 20%	Total body Z-score <−2.0; 7% versus 1% in HIV-negative peers LS Z-score<−2.0; 4% versus 1% in HIV-negative peers	Higher peak viral load and CD4% Ever used indinavir
Bunders [30]	N=66 Mean age 6.7 years Black 62%	3.4 years (IQR 1.5–5.2) 72% use PI, mainly nelfinavir	Spinal BMD Z-score<−2.0=8%
Puthanakit [31]	N=100 Age 14.3 years Thai 100%	7.0 years (4.3–8.7) Nadir CD4=114 (31–226) cell/mm3	LS Z-score<−2.0; 24%	Height-for-age Z-score<−1.5 Ever have WHO stage 4
Schtscherbyna [32]	N=74 Age 17.3 (SD 1.8) years White 36.5% Non-white 63.5%	11.1 years (SD 3.5) 91% on ART (19% NNRTI, 72% PI)	Low total body or lumbar spine in 32.4% of cohort Use of TDF is associated with lower lumbar spine Z-score: −1.8 (1.1) vs. −1.3 (0.9) Use of protease inhibitor is associated with LS Z-score −1.7 (1.1) vs. −1.1 (0.9)	Weight, BMI, nutrition, use of tenofovir and protease inhibitors

ART=antiretroviral therapy; N=number; IQR=interquartile ratio; PI=protease inhibitor; NNRTI=non-nucleoside reverse transcriptase inhibitor; BMD=bone mineral density; LS=lumbar spine; SD=standard deviation; BMI=body mass index.