Rukuni, Ruramayi, Gregson, Celia L., Kahari, Cynthia, Kowo, Farirayi, McHugh, Grace, Munyati, Shungu, Mujuru, Hilda, Ward, Kathryn, Filteau, Suzanne, Rehman, Andrea M. and Ferrand, Rashida A. (2020) The impact of vertical HIV infection on child and adolescent skeletal development in Harare, Zimbabwe (IMVASK Study): a protocol for a prospective cohort study. BMJ Open, 10 (2), 1-10, [e031792]. (10/2/e031792.info).
Abstract
Introduction: the scale-up of antiretroviral therapy (ART) across sub-Saharan Africa (SSA) has reduced mortality so that increasing numbers of children with HIV (CWH) are surviving to adolescence. However, they experience a range of morbidities due to chronic HIV infection and its treatment. Impaired linear growth (stunting), is a common manifestation, affecting up to 50% of children. However, the effect of HIV on bone and muscle development during adolescent growth is not well characterised. Given the close link between pubertal timing and musculoskeletal development, any impairments in adolescence are likely to impact on future adult musculoskeletal health. We hypothesize that bone and muscle mass accrual in CWH is reduced, putting them at risk of reduced bone mineral density (BMD) and muscle function and increasing fracture risk. This study aims to determine the impact of HIV on BMD and muscle function in peri-pubertal children on ART in Zimbabwe. Methods and analysis: CWH (n=300) and without HIV (n=300), aged 8-16 years, established on ART, will be recruited into a frequency-matched prospective cohort study and compared. Musculoskeletal assessments including dual-energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT), grip strength and standing long jump will be conducted at baseline and after one year. Linear regression will be used to estimate mean size-adjusted bone density and Z-scores by HIV status (i.e. total-body less-head (TBLH) bone mineral content (BMC) for lean mass adjusted for height (TBLH BMCLBM) and lumbar spine bone mineral apparent density (LS BMAD). The prevalence of low size-adjusted BMD (i.e. Z-scores <-2) will also be determined. Ethics and dissemination: ethical approval for this study has been granted by the Medical Research Council of Zimbabwe and the LSHTM Ethics Committee. Baseline and longitudinal analyses will be published in peer reviewed journals and disseminated to research communities.
More information
Identifiers
Catalogue record
Export record
Altmetrics
Contributors
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.