title: Association of Dyslipidemia and Glucose Abnormalities With Antiretroviral Treatment in a Cohort of HIV-Infected Latin American Children.
abstract: To estimate the incidence of lipid and glucose abnormalities and assess their association with exposure to antiretroviral (ARV) regimens among perinatally HIV-infected Latin American children.
  
  
  
  Longitudinal cohort study.
  
  
  
  Data were analyzed from the Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative Pediatric Latin American Countries Epidemiologic Study. The incidence of dyslipidemia [total cholesterol >200 mg/dL, HDL < 35 mg/dL, LDL ≥ 130 mg/dL, triglycerides > 110 mg/dL (age < 10 years) or >150 mg/dL (≥10 years)] and fasting glucose abnormalities [homeostasis model assessment of insulin resistance >2.5 (Tanner stage 1) or >4.0 (Tanner stage > 1); impaired glucose: 110 to <126 mg/dL; diabetes: ≥126 mg/dL] was estimated. Proportional hazards regression was used to evaluate the risk of abnormalities associated with ARV regimen, adjusted for covariates.
  
  
  
  There were 385 children eligible for analysis (mean age 6.6 years). Incident cholesterol abnormalities were reported in 18.1% of participants [95% confidence interval (CI): 14.1% to 22.8%], HDL and LDL cholesterol abnormalities in 19.6% (15.1%-24.7%) and 15.0% (11.3%-19.5%), respectively, and triglyceride abnormalities in 44.2% (37.7%-50.8%). In multivariable analysis, ARV regimen was only associated with triglyceride abnormalities; participants receiving a protease inhibitor (PI)-containing regimen were 3.6 times as likely to experience a triglyceride abnormality as those receiving no ARVs (95% CI: 1.3 to 10.5; P = 0.0167). The cumulative incidence of insulin resistance was 3.8% (1.8%-7.1%); there were no incident cases of diabetes and only 2 of impaired fasting glucose.
  
  
  
  Children receiving PI-containing regimens were at increased risk of developing triglyceride abnormalities. Continued monitoring of lipid levels in children receiving PI-containing regimens appears warranted.
authors: *Laboratório de Pesquisa em HIV/AIDS, Universidade de Caxias do Sul, Caxias do Sul, RS, Brazil; †Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; ‡Westat, Rockville, MD; §Departamento de Saúde Coletiva, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil; ‖Departamento de Estatística, Faculdade de Matemática, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; ¶Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil; #Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da, Universidade de São Paulo, São Paulo, Brazil; **Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; ††Hospital Infantil de México Federico Gómez, Ciudad de México, México; and ‡‡Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD.
authors: Machline P
authors: MP
authors: Paganella
authors: Rachel A
authors: RA
authors: Cohen
authors: Donald R
authors: DR
authors: Harris
authors: Ricardo
authors: R
authors: de Souza Kuchenbecker
authors: Rosa D
authors: RD
authors: Sperhacke
authors: Sergio K
authors: SK
authors: Kato
authors: Carmem L
authors: CL
authors: Oliveira da Silva
authors: Fernanda T
authors: FT
authors: Sturzbecher
authors: Ricardo H S
authors: RH
authors: Oliveira
authors: Noris
authors: N
authors: Pavía-Ruz
authors: Rohan
authors: R
authors: Hazra
mesh_terms: D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D050171:Dyslipidemias / Q000139:chemically induced*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male
chemical_list: D044966:Anti-Retroviral Agents