Background: Complex interactions between endocrine (1,25(OH)2D, PTH, Sex hormones, GH) and immune factors (IL-1, IL-6, IL-11, TNF-α) regulate bone homeostasis: it is so possible that severe immunological diseases can modify bone metabolism. Adult patients with HIV infection have enhanced levels of proinflammatory cytokines with 1,25(OH)2D deficiency and marked alterations in bone turnover markers.
Objective: To test bone turnover markers in children with connatal HIV-infection.
Design and methods: In 9 children (age: 1 month- 14 years) with congenital HIV-infection, followed since diagnosis, we tested a bone formative marker ( Osteocalcin ) and a bone resorptive marker (ICTP); our clinical and biochemical follow-up were prolonged for 3
years. Osteocalcin and ICTP serum concentrations were correlated with clinical and haematological parameters, antiretroviral therapy, auxological patterns of each patient.
Results and conclusions: Serum concentrations of Osteocalcin and ICTP were abnormal in 52% of samples tested. In 21% of our patients Osteocalcin levels were > + 2 SDS, in 31% were < - 2 SDS for age. In 55% of determinations ICTP levels were pathological: in 7% were > + 2SDS, while in 48% were < - 2 SDS. During follow-up years both markers showed significant variability, without any reciprocal statistically significative correlation. Evaluation of auxological data (statural and ponderal growth, Tanner stage), viremic levels, CD4, CD8, CD4/CD8 levels, clinical stage,
antiretroviral drugs had not a statistically significative correlation with Osteocalcin or ICTP. Authors conclude that important dispersion of examined results and frequency of pathological levels of tested bone markers are not consensual with literature data about adult patients. It is possible due to extreme clinical variability of HIV syndrome in childhood, that is why every child could manifest a particular clinical and haematological evolution, with an individual bone turnover.
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