title: Insulin Resistance and Markers of Inflammation in HIV-infected Ugandan Children in the CHAPAS-3 Trial.
abstract: Few studies have investigated metabolic complications in HIV-infected African children and their relation with inflammation.
  
  
  
  We compared baseline and changes in insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR)] and in markers of inflammation over 48 weeks, in a subset of antiretroviral therapy (ART)-naive Ugandan children from the Children with HIV in Africa-Pharmacokinetics and Adherence/Acceptability of Simple Antiretroviral Regimens trial randomized to zidovudine-, stavudine- or abacavir (ABC)-based regimen. Nonparametric methods were used to explore between-group and within-group differences, and multivariable analysis to assess associations of HOMA-IR.
  
  
  
  One-hundred eighteen children were enrolled, and median age (interquartile range) was 2.8 years (1.7-4.3). Baseline median HOMA-IR (interquartile range) was 0.49 (0.38-1.07) and similar between the arms. At week 48, median relative changes in HOMA-IR were 14% (-29% to 97%) in the zidovudine arm, -1% (-30% to 69%) in the stavudine arm and 6% (-34% to 124%) in the ABC arm (P ≤ 0.03 for all the arms compared with baseline, but P = 0.90 for between-group differences). Several inflammation markers significantly decreased in all study arms; soluble CD14 increased on ABC and did not change in the other 2 arms. In multivariate analysis, only changes in soluble CD163 were positively associated with HOMA-IR changes.
  
  
  
  In ART-naive Ugandan children, HOMA-IR changed significantly after 48 weeks of ART and correlated with monocyte activation.
authors.affiliation: From the *Case Western Reserve University, and†Rainbow Babies and Children's Hospital, Cleveland, Ohio; ‡Joint Clinical Research Centre, and §Makerere University College of Health Sciences, Kampala, Uganda; ¶MRC Clinical Trials Unit University College, and ‖Institute of Child Health University College, London, United Kingdom.
authors.forename: Sahera
authors.initials: S
authors.lastname: Dirajlal-Fargo
authors.forename: Victor
authors.initials: V
authors.lastname: Musiime
authors.forename: Adrian
authors.initials: A
authors.lastname: Cook
authors.forename: Grace
authors.initials: G
authors.lastname: Mirembe
authors.forename: Julia
authors.initials: J
authors.lastname: Kenny
authors.forename: Ying
authors.initials: Y
authors.lastname: Jiang
authors.forename: Sara
authors.initials: S
authors.lastname: Debanne
authors.forename: Nigel
authors.initials: N
authors.lastname: Klein
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
mesh_terms: D015415:Biomarkers / Q000097:blood* / Q000378:metabolism; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D014454:Uganda
chemical_list: D015415:Biomarkers