Prevalence of fat redistribution and metabolic disorders in human immunodeficiency virus-infected children.
In this study we assessed the prevalence of fat redistribution and metabolic disorders in a population of HIV-infected children on antiretroviral treatment. To make associations with epidemiological parameters, clinical-immune status, viral load and highly active antiretroviral therapy (HAART), we performed a cross-sectional study in HIV-infected children. Epidemiological parameters (age, sex, family history), clinical and immune status, viral load, and duration of antiretroviral treatment (ART) and HAART, including protease inhibitors, were recorded. Presence of clinical signs of fat redistribution and lipid, glucose and lactic acid levels were evaluated. A total of 56 HIV-infected children, including 30 boys (54%), aged between 21 months and 18 years (mean 9.5 years) were studied. In all, 49 patients (87.5%) were receiving ART (mean duration 4 years) and 43 (77%) were receiving HAART (mean duration 3.6 years). Fat redistribution or lipodystrophy was present in 14 patients (25%); seven had lipohypertrophy (12.5%), two lipoatrophy (3.5%) and five a mixed pattern (8.9%). Fat redistribution was higher in children older than 11 years (50%). Of the lipodystrophic patients, 71.4% presented hypertriglyceridaemia (> 130 mg/dl) and 57% hypercholesterolaemia (> 180 mg/dl). We found significant associations between lipodystrophy and age, ART and HAART duration and hypertriglyceridaemia ( P < 0.001, 0.002, 0.016 and < 0.001, respectively), but no significant association with sex, family history, clinical or immune status and viral load.


CONCLUSIONS
The prevalence of lipodystrophy was 25% (95% confidence interval 14.8-34.6) with lipohypertrophy being the commonest pattern. Clinical fat redistribution was significantly associated with older age, duration of antiretroviral treatment and highly active antiretroviral therapy and hypertriglyceridaemia.
Sánchez Torres
Ana María
AM
Department of Paediatrics, Division of Infectious Diseases, La Paz Children's Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain.
Munoz Muniz
Raquel
R
Madero
Rosario
R
Borque
Clementina
C
García-Miguel
María Jesús
MJ
De José Gómez
María Isabel
MI
D000293:Adolescent; D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000150:complications; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D015228:Hypertriglyceridemia / Q000150:complications; D007223:Infant; D008297:Male; D015995:Prevalence
D044966:Anti-Retroviral Agents