Trial reportAIDS (London, England)2016
Efavirenz is associated with higher bone mass in South African children with HIV.
Trial report in AIDS (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Assessing bone mineral density in children and adolescents living with HIV and on treatment with tenofovir disoproxil fumarate: a systematic review.Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo · 2023Pooled it
- Longitudinal Evaluation of Bone Safety in Children and Adolescents With HIV-1 Starting Tenofovir Alafenamide-Containing Antiretroviral Therapy.Journal of the Pediatric Infectious Diseases Society · 2025Trial
- Decreased bone turnover in HIV-infected children on antiretroviral therapy.Archives of osteoporosis · 2018Trial
- Switching to Efavirenz Versus Remaining on Ritonavir-boosted Lopinavir in Human Immunodeficiency Virus-infected Children Exposed to Nevirapine: Long-term Outcomes of a Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Trial
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- The State of the Science on Chronic Comorbidities and Aging in Children and Adolescents with perinatally-acquired HIV.Current HIV/AIDS reports · 2025Review
- Changes in peripheral quantitative computed tomography measured bone density, size, and strength in Zimbabwean children with and without HIV over one year: a cohort study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
- Association Between Vitamin D Insufficiency and Impaired Bone Density Among Adolescents With Perinatally Acquired HIV Infection.Open forum infectious diseases · 2024Article
- Health-Related Physical Fitness Evaluation in HIV-Diagnosed Children and Adolescents: A Scoping Review.International journal of environmental research and public health · 2024Article
- Prevalence and Causes of Vitamin D Deficiency in a Cohort of Greek HIV-Infected Individuals: A Prospective, Single Center, Observational Study.Current HIV research · 2024Observational
- Article
- Article
- Evaluation of submaximal endurance in young children living with HIV.The South African journal of physiotherapy · 2022Article
- Effect of HIV infection on growth and bone density in peripubertal children in the era of antiretroviral therapy: a cross-sectional study in Zimbabwe.The Lancet. Child & adolescent health · 2021Article
- Bone outcomes in virally suppressed youth with HIV switching to tenofovir disoproxil fumarate.Southern African journal of HIV medicine · 2021Article
- Behavioral Functioning and Quality of Life in South African Children Living with HIV on Antiretroviral Therapy.The Journal of pediatrics · 2020Article
- Prevalence and predictors of bone health among perinatally HIV-infected adolescents.AIDS (London, England) · 2020Article
- Article
- Bone turnover markers in children and adolescents with environmentally determined short stature, living in the oil and gas processing region.Environmental science and pollution research international · 2020Article
- Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundWe investigate if switching from a ritonavir-boosted lopinavir (LPV/r)-based to an efavirenz-based antiretroviral therapy (ART) regimen is associated with beneficial bone development.
methodsThe CHANGES Bone Study follows HIV-infected children who participated in a noninferiority randomized trial in Johannesburg, South Africa evaluating the safety and efficacy of preemptive switching to efavirenz (n = 106) compared with remaining on LPV/r (n = 113). HIV-uninfected children were also recruited. Whole-body and lumbar spine bone mineral content (BMC) were assessed by dual-energy X-ray absorptiometry at a cross-sectional visit. BMC Z-scores adjusted for sex, age, and height were generated. Physical activity and dietary intake were assessed. CD4 percentage and viral load were measured. We compared bone indices of HIV-infected with HIV-uninfected children and LPV/r with efavirenz by intent-to-treat.
resultsThe 219 HIV-infected (52% boys) and 219 HIV-uninfected (55% boys) children were 6.4 and 7.0 years of age, respectively. Mean ART duration for HIV-infected children was 5.7 years. Whole-body BMC Z-score was 0.17 lower for HIV-infected children compared with HIV-uninfected children after adjustment for physical activity, dietary vitamin D and calcium (P = 0.03). Whole-body BMC Z-score was 0.55 higher for HIV-infected children switched to efavirenz compared with those remaining on LPV/r after adjustment for physical activity, dietary vitamin D and calcium, CD4 percentage, and viral load (P < 0.0001).
conclusionSouth African HIV-infected children receiving ART have lower bone mass compared with HIV-uninfected controls. Accrued bone mass is positively associated with switching to efavirenz-based ART compared with remaining on LPV/r, providing additional rationale for limiting LPV/r exposure once viral suppression has been achieved.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.