Dyslipidemia in HIV Infected Children Receiving Highly Active Antiretroviral Therapy.
OBJECTIVE
To assess the prevalence of dyslipidemia and lipodystrophy in Indian children receiving non-nucleoside reverse transcriptase inhibitor (NNRTI) based highly active antiretroviral therapy (HAART) and to determine the associated risk factors for the same.


METHODS
The present cross-sectional study was conducted at a Pediatric Clinic of a tertiary care teaching center in India, from May 2011 through December 2012. HIV infected children aged 5-15 y were enrolled if they did not have any severe disease or hospital admission within last 3 mo or receive any medications known to affect the lipid profile. Eighty-one children were on highly active antiretroviral therapy (HAART) for at least 6 mo and 16 were receiving no antiretroviral therapy (ART). Participants' sociodemographic, nutritional, clinical, and laboratory data were recorded in addition to anthropometry and evidence of lipodystrophy. Fasting lipid profile, apolipoprotein A1 and B levels were done for all the children.


RESULTS
Among the children on highly active antiretroviral therapy (HAART), 38.3 % had dyslipidemia and 80.2 % had lipodystrophy, while 25 % antiretroviral therapy (ART) naïve HIV infected children had dyslipidemia. No clinically significant risk factors could be identified that increased the risk of dyslipidemia or lipodystrophy in children on highly active antiretroviral therapy (HAART).


CONCLUSIONS
There is a high prevalence of dyslipidemia and lipodystrophy in Indian children with HIV infection with an imminent need to establish facilities for testing and treatment of these children for metabolic abnormalities.
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
Anirban
A
Mandal
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
Aparna
A
Mukherjee
Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, 110029, India.
R
R
Lakshmy
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
Sushil K
SK
Kabra
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India. rakesh_lodha@hotmail.com.
Rakesh
R
Lodha
D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007194:India / Q000453:epidemiology; D008060:Lipodystrophy / Q000209:etiology*; D008297:Male; D015995:Prevalence; D012307:Risk Factors
Dyslipidemia; HIV infection; Highly active antiretroviral therapy; Lipodystrophy