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Changes in bone mineral density and calcium metabolism in HIV-infected children and adolescents

Abstract

Highly active antiretroviral therapy (HAART) has reduced morbidity and mortality of HIV-infected children. However, this therapy may be associated with adverse events such as changes in body composition and bone metabolism. The decrease in bone mineralization has been seen in a large percentage of HIV-infected patients and may be the result of multiple causes related to the host, the virus or the antiretroviral treatment of HIV infection. Objective: To evaluate the prevalence of changes in bone mineral density and calcium metabolism in HIV-infected children and adolescents followed at Ceadipe - UNIFESP - EPM. Methods: A prospective nonrandomized clinical study with HIV-infected patients aged 5 -20 years, (N = 100. Convenience sample. The procedures listed below will be conducted in two stages, namely the visit of inclusion or time zero (T0) and the visit after 12 months (T12):measurement of weight and height, blood samples (10 mL) for determination of 25 hydroxy vitamin D, parathyroid hormone, total proteins and fractions, phosphorus, alkaline phosphatase, urine and serum calcium and DEXA. If detected reductions in bone mineral density in the first evaluation, it will be given supplemental doses of calcium and vitamin D (500 to 1000 mg / day of calcium according to the daily intake of the patient, and 400 to 800 IU of vitamin D depending on the age and the severity of the case). The biochemical measurements and DEXA will be repeated after 6 months. Descriptive statistics will be used to present the results in tables. Variables with normal distribution: the statistical treatment will be parametric (linear correlation test of Pearson, Student's t test for independent samples and ANOVA. Variables without normal distribution: the statistical analysis is nonparametric (Mann-Whitney and Kruskal-Wallis, Fisher's test or chi-square). (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
CARMO, FABIANA BONONI; TERRERI, MARIA TERESA; DE MENEZES SUCCI, REGINA CELIA; BELTRAO, SUENIA VASCONCELOS; TOME BARBOSA GOUVEA, AIDA DE FATIMA; CRUZ PAULINO, ERICA REGINA; MACHADO, DAISY MARIA. Bone mineral density and vitamin D concentration: the challenges in taking care of children and adolescents infected with HIV. Brazilian Journal of Infectious Diseases, v. 21, n. 3, p. 270-275, . (11/20882-2)

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