title: Body fat distribution in perinatally HIV-infected and HIV-exposed but uninfected children in the era of highly active antiretroviral therapy: outcomes from the Pediatric HIV/AIDS Cohort Study.
abstract: BACKGROUND
  Associations between abnormal body fat distribution and clinical variables are poorly understood in pediatric HIV disease.
  
  
  OBJECTIVE
  Our objective was to compare total body fat and its distribution in perinatally HIV-infected and HIV-exposed but uninfected (HEU) children and to evaluate associations with clinical variables.
  
  
  METHODS
  In a cross-sectional analysis, children aged 7-16 y in the Pediatric HIV/AIDS Cohort Study underwent regionalized measurements of body fat via anthropometric methods and dual-energy X-ray absorptiometry. Multiple linear regression was used to evaluate body fat by HIV, with adjustment for age, Tanner stage, race, sex, and correlates of body fat in HIV-infected children. Percentage total body fat was compared with NHANES data.
  
  
  RESULTS
  Males accounted for 47% of the 369 HIV-infected and 51% of the 176 HEU children. Compared with HEU children, HIV-infected children were older, were more frequently non-Hispanic black, more frequently had Tanner stage ≥3, and had lower mean height (-0.32 compared with 0.29), weight (0.13 compared with 0.70), and BMI (0.33 compared with 0.63) z scores. On average, HIV-infected children had a 5% lower percentage total body fat (TotF), a 2.8% lower percentage extremity fat (EF), a 1.4% higher percentage trunk fat (TF), and a 10% higher trunk-to-extremity fat ratio (TEFR) than did the HEU children and a lower TotF compared with NHANES data. Stavudine use was associated with lower EF and higher TF and TEFR. Non-nucleotide reverse transcriptase inhibitor use was associated with higher TotF and EF and lower TEFR.
  
  
  CONCLUSIONS
  Although BMI and total body fat were significantly lower in the HIV-infected children than in the HEU children, body fat distribution in the HIV-infected children followed a pattern associated with cardiovascular disease risk and possibly related to specific antiretroviral drugs.
authors: Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA, USA. jacobson@sdac.harvard.edu
authors: Denise L
authors: DL
authors: Jacobson
authors: Kunjal
authors: K
authors: Patel
authors: George K
authors: GK
authors: Siberry
authors: Russell B
authors: RB
authors: Van Dyke
authors: Linda A
authors: LA
authors: DiMeglio
authors: Mitchell E
authors: ME
authors: Geffner
authors: Janet S
authors: JS
authors: Chen
authors: Elizabeth J
authors: EJ
authors: McFarland
authors: William
authors: W
authors: Borkowsky
authors: Margarita
authors: M
authors: Silio
authors: Roger A
authors: RA
authors: Fielding
authors: Suzanne
authors: S
authors: Siminski
authors: Tracie L
authors: TL
authors: Miller
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue; D000293:Adolescent; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active; D050218:Body Fat Distribution; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology / Q000635:transmission; D006679:HIV Seropositivity / Q000188:drug therapy / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D016014:Linear Models; D008297:Male; D044469:Racial Groups; D012737:Sex Factors