title: Long-term body composition and metabolic changes in HIV-infected children switched from stavudine to tenofovir and from protease inhibitors to efavirenz.
abstract: This is an 8-year cohort study of 24 HIV-infected patients aged 5-17 years to assess body composition and metabolic changes after switching from lamivudine + stavudine (d4T) + protease inhibitors (PI) to lamivudine + tenofovir (TDF) + efavirenz (EFV). Body composition (dual-energy X-ray absorptiometry) and cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, glucose and insulin were measured annually. Linear mixed models and generalized linear mixed models were used to evaluate time changes of the outcome of interest. Body mass index increased linearly by 0.3 kg/m(2)/year (p < 0.001); waist circumference increased non-linearly from 68 to 74 cm (p = 0.004 for the linear term and p = 0.04 for the quadratic term). Percent body fat, percent trunk fat and percent bone mineral content increased linearly by 0.6%/year (p = 0.005), 1.2%/year (p < 0.001) and 0.02%/year (p = 0.04), respectively. Percent arm fat remained stable (p = 0.5), and percent leg fat decreased linearly by 1.2%/year (p < 0.001). The probability of low HDL was 0.2% at baseline and remained stable during the study. The probability of high triglycerides was 3% at baseline and increased linearly to become 11% at the 8th year of follow-up (p = ns). The probability of high glucose was 1% for the whole study duration.
  
  
  CONCLUSIONS
  patients, after switching from d4T to TDF and from PI to EFV, show most of the changes in anthropometry and body composition associated with normal growth and no frankly pathological change in metabolic parameters.
authors: Department of Pediatrics, University of Milan, L. Sacco Hospital, Milan, Italy. fabiano.valentina@hsacco.it
authors: Valentina
authors: V
authors: Fabiano
authors: Vania
authors: V
authors: Giacomet
authors: Alessandra
authors: A
authors: Viganò
authors: Giorgio
authors: G
authors: Bedogni
authors: Sara
authors: S
authors: Stucchi
authors: Lucia
authors: L
authors: Cococcioni
authors: Stefano
authors: S
authors: Mora
authors: Gian Vincenzo
authors: GV
authors: Zuccotti
mesh_terms: D015502:Absorptiometry, Photon; D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000293:Adolescent; D000480:Alkynes; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D048588:Benzoxazines / Q000008:administration & dosage*; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003521:Cyclopropanes; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D063065:Organophosphonates / Q000008:administration & dosage*; D018119:Stavudine / Q000008:administration & dosage*; D000068698:Tenofovir
chemical_list: D000480:Alkynes; D044966:Anti-Retroviral Agents; D048588:Benzoxazines; D001786:Blood Glucose; D003521:Cyclopropanes; D008055:Lipids; D063065:Organophosphonates; D019259:Lamivudine; D000068698:Tenofovir; D018119:Stavudine; D000225:Adenine; C098320:efavirenz
references: J Endocrinol Invest. 2006 Jul-Aug;29(7):581-93
references: 16957405
references: AIDS. 2006 Jun 26;20(10):1407-14
references: 16791015
references: Pediatrics. 2006 Sep;118(3):e711-8
references: 16923923
references: Int J Obes (Lond). 2013 Jul;37(7):943-6
references: 23478429
references: J Pediatr. 2004 Oct;145(4):439-44
references: 15480363
references: AIDS. 2006 Oct 24;20(16):2043-50
references: 17053350
references: J Acquir Immune Defic Syndr. 2005 Dec 1;40(4):448-50
references: 16280700
references: Pediatr Diabetes. 2007 Oct;8(5):299-306
references: 17850473
references: Eur J Pediatr. 2005 May;164(5):271-6
references: 15650834
references: Clin Infect Dis. 2012 Aug;55(3):461-8
references: 22573848
references: AIDS. 2004 Apr 30;18(7):1029-36
references: 15096806
references: Antivir Ther. 2010;15(7):1053-8
references: 21041922
references: JAMA. 2002 Jul 10;288(2):207-15
references: 12095385
references: J Acquir Immune Defic Syndr. 2012 Mar 1;59(3):314-24
references: 22205436
references: Clin Infect Dis. 2004 Jan 15;38(2):263-70
references: 14699460
references: Bone. 2010 Jun;46(6):1633-8
references: 20211284
references: AIDS. 2004 Jul 2;18(10):1443-51
references: 15199321
references: AIDS. 2004 Mar 26;18(5):819-21
references: 15075521
references: Antivir Ther. 2007;12(3):297-302
references: 17591019
references: Am J Physiol. 1996 Dec;271(6 Pt 1):E941-51
references: 8997211
references: Int J Infect Dis. 2012 Dec;16(12):e872-8
references: 23031418
references: Antivir Ther. 2005;10(8):917-24
references: 16430197
references: Front Biosci (Elite Ed). 2010 Jun 01;2:1265-74
references: 20515800
references: JAMA. 2004 Jul 14;292(2):191-201
references: 15249568
references: Am J Clin Nutr. 2011 Dec;94(6):1485-95
references: 22049166
references: AIDS. 2009 Mar 27;23(6):661-72
references: 19279441
references: Clin Infect Dis. 2000 Nov;31(5):1266-73
references: 11073762
references: Antivir Ther. 2007;12(3):407-15
references: 17591031
references: J Acquir Immune Defic Syndr. 2007 Feb 1;44(2):139-47
references: 17106274
references: Pediatrics. 2003 Mar;111(3):e275-81
references: 12612284
references: Diabetes Care. 2004 Jun;27(6):1487-95
references: 15161807
references: Pediatr Infect Dis J. 2012 May;31(5):469-73
references: 22301477
references: Arch Dis Child. 1976 Mar;51(3):170-9
references: 952550
references: Eur J Pediatr. 2007 Jan;166(1):13-21
references: 16896646
references: J Pediatr. 2008 Apr;152(4):582-4
references: 18346519
references: J Acquir Immune Defic Syndr. 2005 Oct 1;40(2):161-8
references: 16186733
references: Clin Infect Dis. 2010 Oct 15;51(8):963-72
references: 20828304
references: J Acquir Immune Defic Syndr. 2003 May 1;33(1):29-33
references: 12792352