Download Free Medical Decreased bone turnover in HIV-infected children on antiretroviral therapy PowerPoint Presentation

Decreased bone turnover in HIV-infected children on antiretroviral therapy PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Decreased bone turnover in HIV-infected children on antiretroviral therapy

Tags : Pediatrics, Child Health, pediatric practice, pediatrician, health providers, HIV-infected infants, Adolescent Transition, HIV-infected adolescents, epidemiology, south Africa, antiretroviral therapy

Published on : Jul 16, 2020 | Views : 1201 | Downloads : 0

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Decreased bone turnover in HIV-infected children on antiretroviral therapy Stephanie Shiau1, Stephen M. Arpadi1, Renate Strehlau2, Faeezah Patel2, Ndileka Mbete2, Donald J. McMahon1, Louise Kuhn1, Ashraf Coovadia2, Michael T. Yin1 1Columbia University, New York, NY, USA 2University of the Witwatersrand, Johannesburg, South Africa O-12 1 CHANGES Bone Study Team
Slide 2-

HIV and Bone in Children HIV appears to be associated with deficits in childhood bone mass accrual1,2 We previously reported lower bone mineral content (BMC) among South African HIV-infected children who3: Initiated treatment early in life Have excellent virologic control Disruption of bone accrual can compromise adult peak bone mass and increase the risk of later life osteoporosis and fracture 1Jacobson et al. AIDS 2010; 2Mora et al. J Clin Endocrinol Metab 2004; 3Arpadi, Shiau, Strehlau et al. AIDS 2016 (in press) 2
Slide 3-

Mechanisms Unclear ? HIV ↓ Bone Mass 3
Slide 4-

Hypothesized Mechanisms HIV Bone ↓ Formation ↓ P1NP ↓ Bone Mass osteoclast ↑ Bone Resorption ↑ CTX ↑Inflammation ↑ IL-6 ↑ TNFα ↑ sCD14 ↑ hs CRP 4 osteoblast
Slide 5-

Previous Studies HIV Bone ↓ Formation ↓ P1NP ↓ Bone Mass ↑Inflammation ↑ IL-6 ↑ TNFα ↑ sCD14 ↑ hs CRP osteoclast ↑ Bone Resorption ↑ CTX osteoblast 1Yin Clin Endocrinol Metab 2010 1 5
Slide 6-

Study Design CHANGES Bone Study ESRU, Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa 219 HIV-infected children 219 HIV-uninfected controls 180 controls included in this analysis 6
Slide 7-

Measurements 7 Bone mass Whole body BMC by DXA BMC Z-scores (adjusted for sex, age, and height) Bone turnover markers Resorption: CTX (C-telopeptide) Formation: P1NP (procollagen type 1 N-terminal propeptide) Inflammation IL-6 TNF-α sCD14 hs-CRP
Slide 8-

Results: Characteristics 8
Slide 9-

Results: Inflammation Marker HIV+ (N=219) HIV- (N=180) – – ↑ ↑ 9
Slide 10-

HIV ↓ Bone Mass Results: Bone Resorption osteoclast ↑ Bone Resorption CTX ↑Inflammation 10
Slide 11-

HIV ↓ CTX ↓ Bone Mass ↑ Bone Resorption Results: Bone Resorption osteoclast ↑Inflammation 1 0.5 0 *p<0.05 11 1.5 2.5 2 HIV+ HIV- CTX (ng/mL) *
Slide 12-

Results: Bone Formation HIV ↓ Bone Mass Bone ↓ Formation P1NP Inflammation *p<0.05 12 osteoblast
Slide 13-

Results: Bone Formation HIV ↓ Bone Mass Bone ↓ Formation Inflammation osteoblast 640 620 600 580 560 540 520 500 *p<0.05 13 HIV+ HIV- P1NP (ng/mL) ↓ P1NP *
Slide 14-

Results: Correlations *p<0.05 14
Slide 15-

Summary 15 Compared to HIV-uninfected controls, HIV-infected children had: Lower BMC Similar IL-6 and TNF-a Higher sCD14 and hsCRP Lower bone resorption (CTX) and bone formation (P1NP) Bone turnover markers were not strongly correlated with markers of inflammation or BMC In summary, HIV-infected children with virologic suppression on antiretrovirals had lower BMC and lower bone formation
Slide 16-

Implications 16 In HIV-infected children with viral suppression, decreases in bone accrual may occur independently of immune activation HIV viral proteins and/or ART may have a direct effect on osteoblasts resulting in decreased bone formation1-3 Longitudinal studies that include bone turnover markers are needed to understand the dynamics of bone remodeling in growing children 1Fakruddin Arch Virol 2005; 2Butler J Orthop Res 2013; 3Malizia AIDS Res Hum Retro 2007
Slide 17-

Acknowledgements We thank the CHANGES Study Team and Study Participants Funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD 073977, HD 073952) 17

User Presentation
Related Presentations

The global epidemiology of perinatally HIV-infected adolescents

By: MarieAltmann
Views: 1164

Every Newborn: WHO action plan to end preventable deaths

By: MarieAltmann
Views: 1514

Pediatric Drug Pipeline: New Drugs, New Strategies

By: MarieAltmann
Views: 1267

DOES HIV-PCR TESTING OF HIV-EXPOSED INFANTS AT BIRTH REDUCE FOLLOW-UP FOR TESTING AT 4 -14 WEEKS OF AGE?

By: MarieAltmann
Views: 1152

Screening for Social Determinants of Health: Children's Hospitals Respond

By: MarieAltmann
Views: 1317

Growing Up

By: JenniferDwayne
Views: 1620

Disturbios Cardiovasculares

By: mayconw1999
Views: 991

About Consultatia Prenatala

By: timotei
Views: 1540

From Childhood to Adolescence-Eriksons stages of life

By: drdwayn
Views: 1715

Common Childhood Infections and Rashes

By: FrankMarco
Views: 901

MarieAltmann

About : I am a passionate Pediatrician with experience of working in world-renowned hospital systems as well as community-based clinics. I have skills like Advocacy, Team Building, Event Planning, and Public Speaking. A dedicated and worthy healthcare services professional with a MPH focused in International studies from Tulane School of Public Health and Tropical Medicine.
Occupation : Medical Professional
Specialty : MD
Country : United States of America
Website :

HEALTH A TO Z