title: Metabolic Disorders in HIV-Infected Adolescents Receiving Protease Inhibitors.
abstract: Protease inhibitor (PI) may cause abnormal glucose metabolism, abnormal lipid metabolism, and metabolic syndrome in HIV-infected adults but less well studied in Asian adolescents. This cross-sectional study evaluated anthropometric factors, oral glucose tolerance test, and lipid profiles of perinatally HIV-infected Thai adolescents who had received PI-based antiretroviral therapy for at least 6 months. Eighty adolescents were enrolled [median (IQR) age 16.7 (14.6-18.0) years, 42 males]. Metabolic syndrome, prediabetes, and type 2 diabetes mellitus (T2DM) were found in 8 (10%), 17 (22.1%), and 3 (3.8%) adolescents, respectively. Dyslipidemia was found in 56 (70%) adolescents, with hypertriglyceridemia being the most common type. In multivariate analysis, presence of lipohypertrophy (OR: 25.7, 95% CI: 3.2-202.8;p= 0.002) and longer duration of PI use (OR: 1.04, 95% CI: 1.00-1.08;p= 0.023) were associated with metabolic syndrome. Obesity (OR: 7.71, 95% CI: 1.36-43.7;p= 0.021), presence of lipohypertrophy (OR: 62.9, 95% CI: 4.97-795.6;p= 0.001), and exposure to stavudine for ≥6 months (OR: 8.18, 95% CI: 1.37-48.7;p= 0.021) were associated with prediabetes/T2DM, while exposure to tenofovir for ≥6 months reduced the risk (OR: 0.17, 95% CI: 0.04-0.78;p= 0.022). Metabolic disorders were commonly found in adolescents receiving PI. Careful monitoring and early intervention to modify cardiovascular risk should be systematically implemented in this population particularly those with exposure to stavudine.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Jeerunda
authors.initials: J
authors.lastname: Santiprabhob
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Surapong
authors.initials: S
authors.lastname: Tanchaweng
authors.affiliation: Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Sirinoot
authors.initials: S
authors.lastname: Maturapat
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Alan
authors.identifier: 0000-0002-1908-7260
authors.initials: A
authors.lastname: Maleesatharn
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Watcharee
authors.initials: W
authors.lastname: Lermankul
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Sirintip
authors.initials: S
authors.lastname: Sricharoenchai
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Orasri
authors.initials: O
authors.lastname: Wittawatmongkol
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Keswadee
authors.initials: K
authors.lastname: Lapphra
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Wanatpreeya
authors.initials: W
authors.lastname: Phongsamart
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Kulkanya
authors.identifier: 0000-0002-0140-4600
authors.initials: K
authors.lastname: Chokephaibulkit
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D001786:Blood Glucose / Q000737:chemistry; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D050356:Lipid Metabolism; D008055:Lipids / Q000097:blood; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology*; D024821:Metabolic Syndrome / Q000453:epidemiology; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D011236:Prediabetic State / Q000453:epidemiology; D011379:Prognosis; D011480:Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D018119:Stavudine / Q000009:adverse effects / Q000627:therapeutic use; D062606:Tertiary Care Centers
chemical_list: D019380:Anti-HIV Agents; D001786:Blood Glucose; D008055:Lipids; D011480:Protease Inhibitors; D018119:Stavudine