Factors associated with low bone mineral density in a Brazilian cohort of vertically HIV-infected adolescents

Int J Infect Dis. 2012 Dec;16(12):e872-8. doi: 10.1016/j.ijid.2012.07.019. Epub 2012 Sep 30.


Objective: To assess the prevalence and factors associated with low bone mineral density (BMD) in HIV-infected adolescents.

Methods: This was a cross-sectional study of a Brazilian cohort of vertically HIV-infected adolescents. Body composition and lumbar spine (LS) and total body (TB) BMD were estimated by dual-energy X-ray absorptiometry (DXA). Low BMD was considered for a Z-score ≤-2 standard deviations. Pubertal development, anthropometric data, laboratory measurements, antiretroviral regimen, and time of immunological and virological recovery were evaluated as factors associated with a low BMD.

Results: Seventy-four adolescents aged 17.3 ± 1.8 years were studied. Low BMD was present in 32.4% of them. LS and TB BMD Z-scores were positively correlated with weight, body mass index (BMI), BMI Z-score, total body fat, and nutritional status. Patients on tenofovir had lower LS and TB BMD Z-scores. Time on tenofovir was indirectly correlated with LS and TB BMD Z-scores. No difference was found regarding levels of calcium, parathyroid hormone, or 25-hydroxyvitamin D according to BMD status.

Conclusions: Control of the HIV infection, especially before the initiation of puberty, might have a positive influence on bone gain. Body composition and nutritional status had a positive influence on BMD that was more evident in females, suggesting that nutritional intervention may have a positive impact on BMD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon / methods
  • Adolescent
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Body Composition / physiology
  • Body Height
  • Body Mass Index
  • Body Weight
  • Bone Density*
  • Bone Diseases / etiology*
  • Brazil / epidemiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Femur Neck / metabolism
  • HIV Infections / drug therapy
  • HIV Infections / transmission*
  • Humans
  • Infectious Disease Transmission, Vertical*
  • Lumbar Vertebrae / metabolism
  • Male
  • Risk Factors


  • Anti-HIV Agents