Adipokine profiles and lipodystrophy in HIV-infected children during the first 4 years on highly active antiretroviral therapy.
OBJECTIVE
The aim of the study was to evaluate the evolution of plasma adipokines and lipodystrophy in protease inhibitor-naıve vertically HIV-infected children on highly active antiretroviral therapy(HAART).


METHODS
We carried out a multicentre retrospective study of 27 children during 48 months on HAART. Every 3 months, CD4+ T-cells, CD8+ T-cells, viral load (VL), cholesterol, triglycerides, lipoproteins and adipokines were measured. Diagnoses of lipodystrophy were based on clinical examinations.


RESULTS
We found hypercholesterolaemia (4200 mg/dL) in 9.5, 30.4, 21.7, 14.3 and 13.3% of the subjects at months 0, 12, 24, 36 and 48, respectively, and hypertriglyceridaemia (4170 mg/dL) in 14.3, 8.3, 13,4.5 and 0% at the same time-points. During follow-up, and especially at the end of the study, we found an increase in plasma resistin levels and significant increases in total plasminogen activator inhibitor type 1, adiponectin, and leptin levels (Po0.05). We also observed slight increases in the leptin/adiponectin ratio, homeostatic model assessment, and C-peptide values during the first months of treatment followed by a moderate decrease or stabilization after 24 months on HAART.At the end of the study, 12 of the 27 children (44.4%) had lipodystrophy, 10 (37%) had lipoatrophy,and 11 (40.7%) had lipohypertrophy; and only three of the 27 children (11.1%) were diagnosed with lipoatrophy and lipohypertrophy with scores 2.


CONCLUSIONS
HIV-infected children showed an increase in serum adipokine levels, but this was not associated with the emergence of lipodystrophy during 48 months on HAART.
Resino
S
S
Centro Nacional de Microbiologıa, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. sresino@isciii.es
Micheloud
D
D
Lorente
R
R
Bellon
J M
JM
Navarro
M L
ML
Munoz-Fernandez
M A
MA
D054392:Adipokines / Q000378:metabolism* / Q000502:physiology; D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D050171:Dyslipidemias / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D012189:Retrospective Studies; D012720:Severity of Illness Index; D019562:Viral Load
D054392:Adipokines; D044966:Anti-Retroviral Agents; D017395:Plasminogen Activator Inhibitor 1