title: Lipodystrophy in children and adolescents with acquired immunodeficiency syndrome and its relationship with the antiretroviral therapy employed.
abstract: OBJECTIVE
  To evaluate the presence of clinical lipodystrophy in children with the acquired immunodeficiency syndrome and to relate it to the antiretroviral regimen employed, to changes in lipid profile and to insulin resistance.
  
  
  METHODS
  This was a cross-sectional study that evaluated 30 children and adolescents (median age = 9.1 years) with the acquired immunodeficiency syndrome during 2004 and 2005. The following clinical and laboratory evaluations were performed: classification of HIV infection, anthropometric measurements (weight and height), serum glycemia, serum insulin and lipid profile (LDL-c, HDL-c, triglycerides). Lipodystrophy was diagnosed using clinical parameters. The chi-square test was used for statistical analysis.
  
  
  RESULTS
  All of the patients were taking antiretroviral therapy regularly (median duration of 28.4 months); 80% were on three drugs in combination (highly active therapy) and 30% were on protease inhibitors. Lipodystrophy and dyslipidemia were observed in 53.3 and 60% of the patients, respectively. Children on a highly active therapy regimen with protease inhibitors exhibited a higher percentage of mixed lipodystrophy; the difference between these children and the group on highly active therapy without protease inhibitors and the group not on a highly active therapy was statistically significant (44.4 vs. 16.7%; p = 0.004). There was no statistically significant association between the presence of lipodystrophy and sex, age (> 10 years), changes to the lipid profile or insulin resistance.
  
  
  CONCLUSIONS
  The elevated prevalence of dyslipidemia and lipodystrophy observed among children with acquired immunodeficiency syndrome, which exhibited a relationship with the antiretroviral regimen employed, may represent an increased risk for future complications, in particular cardiovascular problems.
authors: Universidade Federal de São Paulo - Escola Paulista de Medicina, São Paulo, Brazil. rssarni@uol.com.br
authors: Roseli Oselka Saccardo
authors: RO
authors: Sarni
authors: Fabíola Isabel Suano de
authors: FI
authors: Souza
authors: Tânia Regina Beraldo
authors: TR
authors: Battistini
authors: Tassiana Sacchi
authors: TS
authors: Pitta
authors: Ana Paula
authors: AP
authors: Fernandes
authors: Priscila Chemiotti
authors: PC
authors: Tardini
authors: Fernando Luis Affonso
authors: FL
authors: Fonseca
authors: Valter Pinho
authors: VP
authors: Dos Santos
authors: Fábio Ancona
authors: FA
authors: Lopez
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000188:drug therapy*; D000293:Adolescent; D000886:Anthropometry; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects* / Q000379:methods; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male
chemical_list: D008055:Lipids