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.
Desai
Ninad
N
Kings County Hospital Center & SUNY-Downstate College of Medicine, Brooklyn, NY 11203, USA. desain@nychhc.org
Mullen
Patricia
P
Mathur
Mudit
M
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