Disminución de la mineralización ósea en el niño con VIH en tratamiento antirretroviral de gran actividad

Rojo Conejo, P.; Ramos Amador, J.T.; García Piñar, L.; Ruano Fajardo, C.; Sánchez Granados, J.M.; González Tomé, M.aI.; Ruiz Contreras, J.

doi:10.1016/S1695-4033(04)78259-4

Article information

Antecedentes

En los países desarrollados, con la introducción del tratamiento antirretroviral de gran actividad (TARGA), la supervivencia y la calidad de vida de los niños infectados por el virus de la inmunodeficiencia humana (VIH) ha mejorado de manera espectacular. Sin embargo, empiezan a observarse en estos pacientes algunas alteraciones metabólicas y óseas que son preocupantes.

Objetivo

Evaluar la prevalencia de alteraciones en la mineralización ósea y los posibles factores asociados en una cohorte de niños infectados por el VIH y que reciben TARGA.

Pacientes y métodos

Se ha realizado una densitometría ósea (DEXA) a 50 niños con infección por VIH de un hospital terciario de Madrid tras una media de 54 meses con TARGA. Posteriormente se ha comparado el grupo con disminución en la mineralización ósea con el que no tiene disminución.

Resultados

Un 40% de los niños presentaban disminución en la densidad mineral ósea (DMO) de los cuales un 36% correspondía a osteopenia (18/50) y un 4% a osteoporosis (2/50). Al comparar el grupo con disminución en la densidad mineral ósea con el que no tiene disminución no se han encontrado diferencias estadísticamente significativas en ninguno de los factores estudiados.

Conclusiones

Existe una elevada prevalencia de disminución en la DMO en nuestra cohorte de niños con infección VIH en TARGA. Todavía se conoce poco la etiología y los factores asociados de esta afectación.

Palabras clave:

VIH

Terapia antirretroviral de gran actividad

Osteopenia

Osteoporosis

Disminución de la densidad mineral ósea

DEXA

Niños

Background

In developed countries, the introduction of highly active antiretroviral therapy (HAART) has greatly improved survival and quality of life in HIV-infected children. Nevertheless, worrisome metabolic and bone alterations are beginning to be observed.

Objective

To evaluate the prevalence of alterations in bone mineral density and possible associated factors in a cohort of HIV-infected children receiving HAART.

Patients and methods

Bone dual energy X-ray absorptiometry (DEXA) was performed in 50 HIV-infected children in a tertiary hospital in Madrid after a median length of HAART of 54 months. Subsequently, the group with bone mineral loss was compared with the group without bone mineral loss.

Results

Forty percent of the children studied had decreased bone mineral density, of which 36% had osteopenia (18/50) and 4% had osteoporosis (2/50). No statistically significant differences were found between the two groups in any of the factors analyzed.

Conclusions

The prevalence of decreased bone mineral density in our cohort of HIV-infected children receiving HAART is high. The etiology and factors associated with this alteration are still not well known.

Key words:

HIV

Highly active antiretroviral therapy

Osteopenia

Osteoporosis

Decreased bone mineral density

DEXA

Children

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