{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:03:14Z","timestamp":1789192994283,"version":"build-2803163510"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T00:00:00Z","timestamp":1706313600000},"content-version":"vor","delay-in-days":1152,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,12,10]],"date-time":"2022-12-10T00:00:00Z","timestamp":1670630400000},"content-version":"vor","delay-in-days":739,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>HIV infection has multi-system adverse effects in children, including on the growing skeleton. We aimed to determine the association between chronic HIV infection and bone architecture (density, size, strength) in peripubertal children. We conducted a cross-sectional study of children aged 8 to 16\u2009years with HIV (CWH) on antiretroviral therapy (ART) and children without HIV (CWOH) recruited from schools and frequency-matched for age strata and sex. Outcomes, measured by tibial peripheral quantitative computed tomography (pQCT), included 4% trabecular and 38% cortical volumetric bone mineral density (vBMD), 4% and 38% cross-sectional area (CSA), and 38% stress\u2013strain index (SSI). Multivariable linear regression tested associations between HIV status and outcomes, stratified by sex and puberty (Tanner 1\u20132 versus 3\u20135), adjusting for age, height, fat mass, physical activity, and socioeconomic and orphanhood statuses. We recruited 303 CWH and 306 CWOH; 50% were female. Although CWH were similar in age to CWOH (overall mean\u2009\u00b1\u2009SD 12.4\u2009\u00b1\u20092.5\u2009years), more were prepubertal (ie, Tanner 1; 41% versus 23%). Median age at ART initiation was 4 (IQR 2\u20137) years, whereas median ART duration was 8 (IQR 6\u201310) years. CWH were more often stunted (height-for-age Z-score &amp;lt;\u22122) than those without HIV (33% versus 7%). Both male and female CWH in later puberty had lower trabecular vBMD, CSA (4% and 38%), and SSI than those without HIV, whereas cortical density was similar. Adjustment explained some of these differences; however, deficits in bone size persisted in CWH in later puberty (HIV*puberty interaction p\u00a0=\u00a00.035 [males; 4% CSA] and p\u00a0=\u00a00.029 [females; 38% CSA]). Similarly, puberty further worsened the inverse association between HIV and bone strength (SSI) in both males (interaction p\u00a0=\u00a00.008) and females (interaction p\u00a0=\u00a00.004). Despite long-term ART, we identified deficits in predicted bone strength in those living with HIV, which were more overt in the later stages of puberty. This is concerning, as this may translate to higher fracture risk later in life. \u00a9 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).<\/jats:p>","DOI":"10.1002\/jbmr.4752","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T03:06:38Z","timestamp":1669345598000},"page":"248-260","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impaired Bone Architecture in Peripubertal Children With HIV, Despite Treatment With Antiretroviral Therapy: A Cross-Sectional Study From Zimbabwe"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7289-5152","authenticated-orcid":false,"given":"Cynthia","family":"Mukwasi-Kahari","sequence":"first","affiliation":[{"name":"The Health Research Unit Zimbabwe (THRU-Zim) Biomedical Research and Training Institute Harare Zimbabwe"},{"name":"Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9967-5822","authenticated-orcid":false,"given":"Andrea M","family":"Rehman","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9695-6378","authenticated-orcid":false,"given":"M\u00edche\u00e1l","family":"\u00d3 Breasail","sequence":"additional","affiliation":[{"name":"Population Health Sciences Bristol Medical School Bristol UK"},{"name":"MRC Nutrition and Bone Health Research Group University of Cambridge Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2111-1311","authenticated-orcid":false,"given":"Ruramayi","family":"Rukuni","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Infectious and Tropical Diseases London School of Hygiene and Tropical Medicine London UK"},{"name":"The Health Research Unit Zimbabwe (THRU-Zim) Biomedical Research and Training Institute Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2449-0027","authenticated-orcid":false,"given":"Tafadzwa","family":"Madanhire","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe (THRU-Zim) Biomedical Research and Training Institute Harare Zimbabwe"},{"name":"Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Chipanga","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe (THRU-Zim) Biomedical Research and Training Institute Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3566-1688","authenticated-orcid":false,"given":"Lynda","family":"Stranix-Chibanda","sequence":"additional","affiliation":[{"name":"Child and Adolescent Health Unit, Faculty of Medicine and Health Sciences University of Zimbabwe Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4994-0779","authenticated-orcid":false,"given":"Lisa K","family":"Micklesfield","sequence":"additional","affiliation":[{"name":"South African Medical Research Council\/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7660-9176","authenticated-orcid":false,"given":"Rashida A","family":"Ferrand","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Infectious and Tropical Diseases London School of Hygiene and Tropical Medicine London UK"},{"name":"The Health Research Unit Zimbabwe (THRU-Zim) Biomedical Research and Training Institute Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7034-6750","authenticated-orcid":false,"given":"Kate A","family":"Ward","sequence":"additional","affiliation":[{"name":"MRC Unit, The Gambia at LSHTM Banjul Gambia"},{"name":"MRC Lifecourse Epidemiology Centre University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6414-0529","authenticated-orcid":false,"given":"Celia 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