Metabolic complications associated with antiretroviral therapy in HIV-infected and HIV-exposed uninfected paediatric patients.
BACKGROUND
HIV-infection has become a chronic disease in paediatric patients with the potential for long-term survival and exposure to antiretroviral (ARV) therapies for 2 decades longer than HIV-infected adults. On the other hand, the administration of ARV to HIV-infected pregnant women has greatly increased both treatment of HIV infection and prevention of perinatal HIV transmission. Therefore, researches aiming to evaluate the safety of ARV therapies in HIV-infected children as well as in HIV-uninfected infants born to HIV-infected mothers are emerging as a new challenge and urgent priority.


METHODS
The purpose of this review is to describe some of the more concerning metabolic complications associated with ARV in paediatric population: hyperlactataemia (HLA) syndromes, body shape abnormalities, disorders of glucose homeostasis and dyslipidaemia in HIV-infected children and adolescents. Frequency, risk factors, clinical findings, prevention and intervention strategies of the previously described abnormalities are discussed in depth.


RESULTS
This review covers our current understanding of HLA syndromes in ARV-exposed uninfected infants born to HIV-infected mothers.


CONCLUSIONS
Prevention of these metabolic complications should assume prominence and future researches should address several of the existing treatment gaps.
Viganò
Alessandra
A
Università di Milano, Luigi Sacco Hospital, Department of Pediatrics, Milan, Italy. alessandra.vigano@unimi.it
Cerini
Chiara
C
Pattarino
Giulia
G
Fasan
Silvia
S
Zuccotti
Gian Vincenzo
GV
D000818:Animals; D019380:Anti-HIV Agents / Q000009:adverse effects*; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism / Q000635:transmission; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008659:Metabolic Diseases / Q000139:chemically induced* / Q000150:complications / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000378:metabolism; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000188:drug therapy / Q000378:metabolism
D019380:Anti-HIV Agents