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 : 1401 | 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

WHO Guidelines on HIV AND INFANT FEEDING

By: MarieAltmann
Views: 1763

Family-Centered Primary Care Medical Home for Children with Medical Complexity

By: MarieAltmann
Views: 1663

Prenatal Pediatrics

By: MarieAltmann
Views: 2078

Impact of tenofovir-containing triple antiretroviral therapy (ART) on bone mineral density in HIV-infected breastfeeding women in sub-Saharan Africa

By: MarieAltmann
Views: 1453

Neonatal and paediatric immunology relevant to HIV persistence

By: MarieAltmann
Views: 1443

Airway Clearance for Patient

By: krazykat92
Views: 1631

An Introduction To Human Genomics

By: KhushbuSG
Views: 814

Dental Caries

By: yourdoctors
Views: 2833

Prenatal Infections

By: FrankMarco
Views: 1381

High-Resource Perspective on Adolescent Transition and Research Priorities

By: MarieAltmann
Views: 1826

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