The IMpact of Vertical HIV infection on child and Adolescent SKeletal development in Harare, Zimbabwe: the IMVASK Study

Increasing numbers of children with HIV are surviving to adulthood due to global roll-out of HIV treatment. However, nearly 50 per cent of children have impaired growth due to HIV, including stunting and delayed puberty. Poor growth directly affects bone development, particularly during adolescence when the pubertal ‘growth-spurt’ occurs, which makes adolescence such a critical period for bone development. The extent to which HIV infection affects the growing skeleton in puberty is unknown. This is important to understand because poor bone growth is a key risk factor for osteoporosis in adulthood and hence a person’s future risk of sustaining a fracture, which can be life-changing and cause pain and disability.

We aim to understand how HIV affects bone growth in children during puberty. We will conduct a study in Harare, Zimbabwe to assess the differences in bone density (the amount of bone mass for a given bone size) between children aged 8-16 years who have HIV and those who do not. We will measure the differences in bone growth in these two groups over the course of a year.

Our findings will determine how HIV affects bone growth and whether children with HIV will require interventions to enhance bone development to try to avoid premature osteoporosis in adulthood.

This grant was awarded under the scheme's previous name of Training Fellowships in Public Health and Tropical Medicine.