The IMVASK Study

The IMpact of Vertical HIV infection on child and Adolescent Skeletal development in Harare, Zimbabwe

Project Timeline: May 2018 – May 2020


Name of Funder: Wellcome Trust UK

Principle Investigator: Ruramayi Rukuni (PhD Candidate)

Project Precis: Impaired linear growth (stunting), is one of the most common manifestations of vertically-acquired HIV which can adversely impact bone and muscle development and function, particularly during adolescence – a critical period of somatic growth. We hypothesize that the accrual of bone mass in children with HIV during growth may be reduced, which will put them at increased risk of adverse musculoskeletal outcomes e.g. fracture risk earlier in life compared to uninfected peers. This study will estimate the impact of HIV infection on musculoskeletal disease in children and inform the need for potential interventions to optimize peak bone mass and reduce risk of osteoporosis in adulthood.

Aim: To determine the impact of HIV infection on bone mineral density (bone mass/bone size) in peri-pubertal children aged 8-16 years established on antiretroviral therapy (ART).

Specific objectives:

  1. To determine the prevalence of low-BMD among children with HIV compared to children without HIV.

  2. To analyse the risk factors for low-BMD among children with HIV.

  3. To compare the rate of bone mass accrual between children with HIV and without HIV.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        


300 children with HIV established on ART and 300 children without HIV, aged 8-16 years will be recruited into a frequency-matched prospective cohort study. Detailed musculoskeletal assessments including dual-energy X-ray absorptiometry (DXA) will be conducted at baseline and one year.