{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:36:51Z","timestamp":1787870211000,"version":"build-2784847793"},"reference-count":51,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Low bone mineral density (BMD) has been described in children and young people with perinatally acquired HIV (PHIV), which may be related to both traditional (e.g. low body mass index and malnutrition) and HIV\u2010related risk factors (e.g. longstanding exposure to HIV and antiretroviral therapy [ART], with immune suppression, chronic immune activation and inflammation). Here, we evaluate BMD in a U.K. cohort of young people with PHIV by age and ART.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This longitudinal, observational study was conducted at a U.K. tertiary PHIV service between November 2018 and March 2022. Bone health was assessed in 130 individuals aged 15\u201319 (<jats:italic>n<\/jats:italic> = 50), 20\u221224 (<jats:italic>n<\/jats:italic> = 50) and 25 years and older (<jats:italic>n<\/jats:italic> = 30) by dual\u2010energy X\u2010ray absorptiometry, bone mineralization and turnover markers. Low BMD was defined as lumbar spine (LS) and\/or femur\u2010BMD z\u2010score below \u22122, relative to age, sex and ethnicity\u2010matched U.K. population\u2010based normative controls. Two\u2010year follow\u2010up evaluation was performed in those aged 15\u221219 (<jats:italic>n<\/jats:italic> = 42) and 20\u221224 years (<jats:italic>n<\/jats:italic> = 43) at enrolment, which included a group who switched from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) ART at baseline. Bayesian logistic regression models examined predictors of low BMD and the effect of ART\u2010backbone on BMD accrual.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, 57% were female and 82% of black ethnicity, with 31 (24%) on TDF\u2010ART. Sixteen (12%) had low baseline BMD. Over a median follow\u2010up duration of 26 (interquartile range [IQR] 25\u201329) months, BMD accrual was lower\u2010than\u2010expected in those aged 15\u221219 years (mean change LS\u2010BMD z\u2010score \u22120.15 (standard deviation [SD] 0.44)), when compared to normative controls. No associations were seen with HIV parameters or the ART regimen. Participants who switched to TAF\u2010ART had similar BMD accrual 26 (IQR 24\u201332) months post switch, when compared to those on non\u2010TAF\/TDF\u2010ART (mean change LS\u2010BMD z\u2010score TAF \u22120.01 [SD 0.41] vs. non\u2010TAF\/TDF \u22120.03 [SD 0.54]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While rates of low BMD were reassuringly low in this cohort, lower\u2010than\u2010expected BMD accrual was observed in younger individuals, relative to normative controls. Overall, BMD accrual on TAF\u2010ART was non\u2010inferior to non\u2010TAF\/TDF\u2010ART.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.70029","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T08:13:39Z","timestamp":1756973619000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Bone health in a U.K. cohort of youth living with perinatally acquired HIV\u20101: a longitudinal study"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3326-9674","authenticated-orcid":false,"given":"Merle","family":"Henderson","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Imperial College London  London UK"},{"name":"900 Clinic Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Blenkinsop","sequence":"additional","affiliation":[{"name":"Department of Mathematics Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Ratmann","sequence":"additional","affiliation":[{"name":"Department of Mathematics Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Great Ormond Street Hospital for Children  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermione","family":"Lyall","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1676-7583","authenticated-orcid":false,"given":"Sarah","family":"Fidler","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Imperial College London  London UK"},{"name":"900 Clinic Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8278-8564","authenticated-orcid":false,"given":"Caroline","family":"Foster","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Imperial College London  London UK"},{"name":"900 Clinic Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the BONDY study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40506-017-0109-9"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed9040074"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.4172\/2155-6113.1000374"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0b013e3283416441"},{"key":"e_1_2_11_6_1","unstructured":"NHS England.Clinical Commissioning Policy: tenofovir alafenamide for treatment of HIV 1 in adults and adolescents [webpage].2017. 21 May 2025; Available from:https:\/\/www.england.nhs.uk\/wp\u2010content\/uploads\/2017\/03\/f03\u2010taf\u2010policy.pdf."},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32835a9b80"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2055-6640(20)30506-9"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2019.05.012"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(21)00133-4"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31826ea89b"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2012.07.019"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000458"},{"key":"e_1_2_11_14_1","volume-title":"Technical update on treatment optimization. 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