Lipodystrophy in pediatric HIV.
OBJECTIVE
To assess fat accumulation in children with HIV/AIDS on long term HAART using CDC defined Body mass Index (BMI) criteria and measured Bioelectric Impedance (BI).


METHODS
Prospective study of 48 HIV infected children (ages 6-15 years) on HAART to determine the incidence of lipodystrophy and evaluate methods of determining body fat accumulation. Lipodystrophy was diagnosed using clinical features-truncal obesity with facial/limb wasting. BMI (weight in kg/height in meters2) was plotted on CDC curves to predict the risk of obesity. BI was performed using Omron's HBF301 body fat analyzer and reported as TBF %/height. Serum cholesterol and triglycerides were measured. Results were compared using ANOVA RESULTS: Average duration of HAART was 2.4 years. Forty five of 48 patients were on protease inhibitors. Fifteen (31%) developed Lipodystrophy, but CDC BMI curves identify only 7/15 as overweight or at risk for obesity. However, TBF/Ht of 30% (using BI) was 85% sensitive and 88% specific in identifying Lipodystrophy. Hyperlipidemia occurred in 28/48 (58%) overall, in 14/15 (93%) diagnosed with lipodystrophy.


CONCLUSIONS
Lipodystrophy is a significant problem in children with HIV/AIDS on HAART. BI is more useful than BMI in identifying patients with abnormal fat accumulation and should be incorporated in their routine assessment in the ambulatory setting.
Kings County Hospital Center & SUNY-Downstate College of Medicine, Brooklyn, NY 11203, USA. desain@nychhc.org
Ninad
N
Desai
Patricia
P
Mullen
Mudit
M
Mathur
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D000293:Adolescent; D017677:Age Distribution; D000704:Analysis of Variance; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects*; D002648:Child; D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D008060:Lipodystrophy / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution