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de Castro JAC, de Lima TR, Silva DAS. Health-Related Physical Fitness Evaluation in HIV-Diagnosed Children and Adolescents: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:541. [PMID: 38791753 PMCID: PMC11121308 DOI: 10.3390/ijerph21050541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/14/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Health-related physical fitness has been widely used to investigate the adverse effects of HIV infection/ART in children and adolescents. However, methods/protocols and cut-points applied for investigating health-related physical fitness are not clear. The aim of this scoping review was to map the literature to identify gaps in knowledge regarding the methods/protocols and cut-points. METHODS A scoping review, following the Joana Briggs Institute (JBI) guidelines, was conducted through ten major databases. Search followed the PCC strategy to construct block of terms related to population (children and adolescents), concept (health-related physical fitness components) and context (HIV infection). RESULTS The search resulted in 7545 studies. After duplicate removal, titles and abstracts reading and full text assessment, 246 studies were included in the scoping review. Body composition was the most investigated component (n = 244), followed by muscular strength/endurance (n = 23), cardiorespiratory fitness (n = 15) and flexibility (n = 4). The World Health Organization growth curves, and nationals' surveys were the most reference values applied to classify body composition (n = 149), followed by internal cut-points (n = 30) and cut-points developed through small populations (n = 16). Cardiorespiratory fitness was classified through cut-points from three different assessment batteries, as well as cut-points developed through studies with small populations, muscular strength/endurance and flexibility were classified through the same cut-points from five different assessment batteries. CONCLUSIONS The research on muscular strength/endurance, cardiorespiratory fitness and flexibility has been scarcely explored. The lack of studies that investigated method usability as well as reference values was evidenced.
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Affiliation(s)
- João Antônio Chula de Castro
- Graduate Program of Physical Education, Sports Center, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil; (J.A.C.d.C.); (T.R.d.L.)
| | - Tiago Rodrigues de Lima
- Graduate Program of Physical Education, Sports Center, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil; (J.A.C.d.C.); (T.R.d.L.)
- Graduate Program in Human Movement Sciences, University of the State of Santa Catarina, Florianopolis 88080-350, SC, Brazil
| | - Diego Augusto Santos Silva
- Graduate Program of Physical Education, Sports Center, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil; (J.A.C.d.C.); (T.R.d.L.)
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Kisitu G, Shabanova V, Naiga F, Nakagwa M, Kekitiinwa AR, Elyanu PJ, Paintsil E. High prevalence of low high-density lipoprotein cholesterol and insulin resistance among children and adolescents living with HIV in Uganda: harbinger for metabolic syndrome? HIV Med 2024; 25:262-275. [PMID: 37879630 DOI: 10.1111/hiv.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Antiretroviral therapy-associated adverse effects and comorbidities are still pervasive in people living with HIV, especially metabolic syndrome (MetS). We investigated the age-dependent prevalence of components of MetS and insulin resistance in children and adolescents living with HIV (CALWH). METHODS A cross-sectional pilot study of CALWH treated at the Baylor Uganda Clinical Centre of Excellence in Kampala, Uganda, May to August 2021. The primary outcome of MetS was defined by both the International Diabetes Federation (IDF) and the Adult Treatment Panel (ATP III) criteria. We estimated the prevalence of MetS and its components for all participants and by the stratification factors. RESULTS We enrolled 90 children and adolescents, aged 6 to <10 years (n = 30), 10 to <16 years (n = 30), and ≥ 16 to <19 years (n = 30). Fifty-one percent were females. The estimated prevalence of MetS was 1.11% (1 of 90) using either IDF or ATPIII criteria for all participants, and 3.33% in the oldest age group. Notably, while only one among study participants met the criterion based on having central obesity or blood pressure, over 55% of participants had one or more IDF component, with 47% having low high-density lipoprotein (HDL) cholesterol. Two participants (6.67%) in the group aged 10 to <16 years met one of the definitions for insulin resistance (IR) using the Homeostatic Model Assessment (HOMA-IR) index. For every 1-year increase in age, HOMA-IR index increased by 0.04 (95% confidence interval: 0.01-0.08; p = 0.02). CONCLUSIONS With increasing survival of CALWH into adulthood, lifetime exposure to ART, the frequency of MetS in this population may rise, increasing the lifetime risk for associated health problems. There is a need to study the natural history of MetS in CALWH to inform preventative and treatment interventions as needed.
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Affiliation(s)
- Grace Kisitu
- Baylor College of Medicine Children's Foundation-Uganda, Block 5 Mulago Hospital, Kampala, Uganda
| | - Veronika Shabanova
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Fairuzi Naiga
- Baylor College of Medicine Children's Foundation-Uganda, Block 5 Mulago Hospital, Kampala, Uganda
| | - Mary Nakagwa
- Baylor College of Medicine Children's Foundation-Uganda, Block 5 Mulago Hospital, Kampala, Uganda
| | - Adeodata R Kekitiinwa
- Baylor College of Medicine Children's Foundation-Uganda, Block 5 Mulago Hospital, Kampala, Uganda
| | - Peter J Elyanu
- Baylor College of Medicine Children's Foundation-Uganda, Block 5 Mulago Hospital, Kampala, Uganda
| | - Elijah Paintsil
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
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Mukhuty K, Harit D, Gomber S, Rathi V. Carotid Intima-Media Thickness and Metabolic Complications in Children with HIV on Antiretroviral Therapy: A Cross-Sectional Study. Indian J Pediatr 2023:10.1007/s12098-023-04950-w. [PMID: 38117439 DOI: 10.1007/s12098-023-04950-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/10/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES To evaluate carotid intima media thickness (CIMT) in children with Human immunodeficiency virus (HIV) on anti-retroviral therapy (ART) and in controls. Also, to compare body mass index (BMI), body fat percentage, skin-fold thickness (SFT), waist-to-height ratio (WHtR), lipid profile, blood pressure, lipodystrophy syndrome (LDS), non-alcoholic fatty liver disease (NAFLD) in children with HIV and in controls and to determine association between lipid profile, LDS, liver amino-transferases, NAFLD, BMI, body fat percentage, SFT, WHtR and CIMT. METHODS This cross-sectional study was done in 7 to 12 y old children attending the ART clinic and receiving ART for ≥6 mo according to 2018 National Aids Control Organization (NACO) guidelines. Thirty age and gender matched controls were enrolled from the pediatrics OPD. Weight, height, BMI, waist circumference, skin fold thickness and blood pressure were recorded. Lipid profile, liver amino-transferases, USG abdomen and CIMT were done with prior appointment. RESULTS The present study had 43% females and 57% males (mean age of 9.33 ± 1.65 y). All cases were on combination ART (mean treatment duration: 59.1 mo). CIMT was significantly increased in cases as compared to controls 0.481 ± 0.087 mm vs. 0.418 ± 0.072 mm (p = 0.003). However, CIMT did not correlate with any other parameter. Cases had significantly higher body fat percentage (17% vs. 13.15%), systolic blood pressure (SBP), SFT, total cholesterol (TC) and low density lipoprotein- cholesterol (LDL-C) as compared to controls. NAFLD was seen in 3 cases (1%), lipohypertrophy in 7 (23%) cases and 5 (16%) controls. CONCLUSIONS Children with HIV on ART have significantly higher CIMT and increased metabolic abnormalities.
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Affiliation(s)
- Koyel Mukhuty
- Department of Pediatrics, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Room No.611, 6th Floor MCH Block, Dilshad Garden, New Delhi, 110095, India
| | - Deepika Harit
- Department of Pediatrics, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Room No.611, 6th Floor MCH Block, Dilshad Garden, New Delhi, 110095, India.
| | - Sunil Gomber
- Department of Pediatrics, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Room No.611, 6th Floor MCH Block, Dilshad Garden, New Delhi, 110095, India
| | - Vinita Rathi
- Department of Radiology, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, India
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Homkham N, Cressey TR, Ingsrisawang L, Bouazza N, Ngampiyaskul C, Hongsiriwon S, Srirojana S, Kanjanavanit S, Bhakeecheep S, Coeur SL, Salvadori N, Treluyer JM, Jourdain G, Urien S. A Population Pharmacokinetic/Pharmacodynamic Model Predicts Favorable HDL Cholesterol Changes Over the First 5 Years in Children Treated With Current Efavirenz-Based Regimens. J Clin Pharmacol 2016; 56:1076-83. [PMID: 26749102 DOI: 10.1002/jcph.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/22/2015] [Accepted: 12/22/2015] [Indexed: 11/07/2022]
Abstract
Efavirenz use is associated with changes in cholesterol concentrations, but it is unclear whether this effect is related to drug concentrations. Using efavirenz and cholesterol plasma concentrations measured in 87 antiretroviral-naive children in Thailand, we assessed indirect response models to describe the evolution of high- and low-density lipoprotein (HDL, LDL) cholesterol concentrations in relation to efavirenz plasma concentrations over time where efavirenz was assumed to either stimulate cholesterol production or inhibit its elimination. Simulations of cholesterol evolution for children with different average efavirenz concentrations (Cav ) according to their assumed status of "fast" or "slow" metabolizers of efavirenz were performed. At treatment initiation, children's median (interquartile range, IQR) age was 8 years (5 to 10), body mass index z-score 0.01 (-1.05 to 1.44), HDL 31 mg/dL (24 to 44), and LDL 83 mg/dL (69 to 100). Median (IQR) efavirenz Cav was 1.7 mg/L (1.3 to 2.1) during the period of observation. The best model describing the evolution of HDL and LDL cholesterol concentrations over time assumed that efavirenz inhibited their elimination. HDL concentrations increase over 5 years, whereas LDL concentrations increased only during the first 4 months and then returned to baseline levels afterward. Simulations predicted that, after 3 years, HDL would increase to 63 mg/dL in "fast" metabolizers and 97 mg/dL in "slow" metabolizers of efavirenz. The population pharmacokinetic-pharmacodynamic (PK-PD) model shows that favorable HDL cholesterol changes can be expected in children with current efavirenz dosing guidelines over 5 years of treatment.
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Affiliation(s)
- Nontiya Homkham
- Institut de Recherche pour le Développement (IRD UMI 174), France, and Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.,Department of Statistics, Faculty of Science, Kasetsart University, Bangkok, Thailand.,Ecole Doctorale de Santé Publique, Université Paris Saclay, France
| | - Tim R Cressey
- Institut de Recherche pour le Développement (IRD UMI 174), France, and Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.,Harvard School of Public Health, Boston, MA, USA
| | - Lily Ingsrisawang
- Department of Statistics, Faculty of Science, Kasetsart University, Bangkok, Thailand
| | - Naïm Bouazza
- Unité de Recherche Clinique Paris Centre, Assistance Publique Hôpitaux de Paris, France.,CIC1419, INSERM & APHP, EAU08 Université Paris Descartes Sorbonne Paris Cité, France
| | | | | | | | | | - Sorakij Bhakeecheep
- National Health Security Office Chiang Mai Branch (Region 1), Chiang Mai, Thailand
| | - Sophie Le Coeur
- Institut de Recherche pour le Développement (IRD UMI 174), France, and Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.,Institut d'Etudes Démographiques, Paris, France
| | - Nicolas Salvadori
- Institut de Recherche pour le Développement (IRD UMI 174), France, and Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Jean Marc Treluyer
- Unité de Recherche Clinique Paris Centre, Assistance Publique Hôpitaux de Paris, France.,CIC1419, INSERM & APHP, EAU08 Université Paris Descartes Sorbonne Paris Cité, France
| | - Gonzague Jourdain
- Institut de Recherche pour le Développement (IRD UMI 174), France, and Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.,Harvard School of Public Health, Boston, MA, USA
| | - Saik Urien
- Unité de Recherche Clinique Paris Centre, Assistance Publique Hôpitaux de Paris, France.,CIC1419, INSERM & APHP, EAU08 Université Paris Descartes Sorbonne Paris Cité, France
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Innes S, Abdullah KL, Haubrich R, Cotton MF, Browne SH. High Prevalence of Dyslipidemia and Insulin Resistance in HIV-infected Prepubertal African Children on Antiretroviral Therapy. Pediatr Infect Dis J 2016; 35:e1-7. [PMID: 26421804 PMCID: PMC4707556 DOI: 10.1097/inf.0000000000000927] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Data describing the true extent of antiretroviral therapy (ART)-induced dyslipidemia and insulin resistance in perinatally infected children on ART in Africa are sparse. METHODS Fasting total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, insulin and glucose were performed on the first 100 of 190 pediatric ART clinic attendees. Diet assessment was performed by a trained dietician. Lipoatrophy was formally graded by consensus between 2 expert HIV pediatricians. Durations of previous ART exposures, clinical stage, pre-ART viral load, nadir and current CD4 were recorded. Dual-energy X-ray absorptiometry was performed on a subset of 42 patients selected semi-randomly. RESULTS Prevalences of insulin resistance, abnormal total cholesterol, LDL, HDL and triglyceride were 10%, 13%, 12%, 13% and 9%, respectively. Overall, 40% had at least 1 lipid abnormality or insulin resistance. Adjusted mean LDL cholesterol increased by 0.24 mmol/L for each additional year of cumulative lopinavir/r exposure (P = 0.03) after correcting for age, gender, body mass index, previous stavudine exposure, age at ART initiation, dietary fat and refined carbohydrate, whereas adjusted mean LDL cholesterol was 0.9 mmol/L higher in children exposed to efavirenz within the previous 6 months (P = 0.02). Adjusting for age, gender and ethnicity, dual-energy X-ray absorptiometry revealed that greater trunk fat and lower peripheral subcutaneous fat were associated with elevated triglycerides but not with total cholesterol, LDL, HDL or homeostatic model assessment. Similarly, the presence of visually obvious lipoatrophy was associated with elevated triglycerides but not with total cholesterol, LDL, HDL, homeostatic model assessment or lactate. CONCLUSIONS Prevalences of insulin resistance and dyslipidemia were high. Cumulative lopinavir is an independent risk factor for dyslipidemia, with efavirenz exposure having only transitory effect.
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Affiliation(s)
- Steve Innes
- Children's Infectious Disease Clinical Research Unit, Stellenbosch University and Tygerberg Children’s Hospital, Cape Town, South Africa
| | - Kameelah L. Abdullah
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, Ca
| | - Richard Haubrich
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, Ca
| | - Mark F. Cotton
- Children's Infectious Disease Clinical Research Unit, Stellenbosch University and Tygerberg Children’s Hospital, Cape Town, South Africa
| | - Sara H. Browne
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, Ca
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Adetokunboh OO, Schoonees A, Balogun TA, Wiysonge CS. Efficacy and safety of abacavir-containing combination antiretroviral therapy as first-line treatment of HIV infected children and adolescents: a systematic review and meta-analysis. BMC Infect Dis 2015; 15:469. [PMID: 26502899 PMCID: PMC4623925 DOI: 10.1186/s12879-015-1183-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 10/06/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Abacavir is one of the recommended nucleoside reverse transcriptase inhibitors (NRTIs) for the treatment of HIV infections among children and adolescents. However, there are concerns that the antiviral efficacy of abacavir might be low when compared to other NRTIs especially among children. There are also concerns that abacavir use may lead to serious adverse events such as hypersensitivity reactions and has potential predisposition to developing cardiovascular diseases METHODS We searched four electronic databases, four conference proceedings and two clinical trial registries in August 2014, without language restrictions. Experimental and observational studies with control groups that examined the efficacy and safety of abacavir-containing regimens in comparison with other NRTIs as first-line treatment for HIV-infected children and adolescents aged between one month and eighteen years were eligible. Two authors independently screened search results, extracted data and assessed the risk of bias of included studies using a pre-specified, standardised data extraction form and validated risk of bias tools. We also assessed the quality of evidence per outcome with the GRADE tool. RESULTS We included two randomised controlled trials (RCTs) and two analytical cohort studies with a total of 10,595 participants. Among the RCTs we detected no difference in virologic suppression after a mean duration of 48 weeks between abacavir- and stavudine-containing regimens (2 trials; n = 326: RR 1.28; 95 % CI 0.67-2.42) with significant heterogeneity (P = 0.02; I(2) = 81 %). We also found no significant differences between the two groups for adverse events and death. After five years of follow-up, virologic suppression improved with abacavir (1 trial; n = 69: RR 1.96; 95 % CI 1.11-3.44). For cohort studies, we detected that the virologic suppression activity of abacavir was less effective than stavudine in both the lopinavir/ritonavir (1 study, n = 2165: RR 0.79, 95 % CI 0.67-0.92) and efavirenz sub-groups (1 study, n = 3204: RR 0.79, 95 % CI 0.67-0.92) respectively. The quality of evidence from RCTs was moderate for virologic suppression but low for death and adverse events, while that of cohort studies was low for all three these outcomes. CONCLUSIONS Available evidence showed little or no difference between abacavir-containing regimen and other NRTIs regarding efficacy and safety when given to children and adolescents as a first-line antiretroviral therapy.
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Affiliation(s)
- Olatunji O Adetokunboh
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7505, South Africa.
- Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7505, South Africa.
| | - Anel Schoonees
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7505, South Africa.
| | - Tolulope A Balogun
- Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7505, South Africa.
| | - Charles S Wiysonge
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7505, South Africa.
- Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7505, South Africa.
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Prevalence of lipodystrophy and metabolic abnormalities in HIV-infected African children after 3 years on first-line antiretroviral therapy. Pediatr Infect Dis J 2015; 34:e23-31. [PMID: 25068287 PMCID: PMC4369579 DOI: 10.1097/inf.0000000000000491] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Most pediatric lipodystrophy data come from high-income/middle-income countries, but most HIV-infected children live in sub-Saharan Africa, where lipodystrophy studies have predominantly investigated stavudine-based regimens. METHODS Three years after antiretroviral therapy (ART) initiation, body circumferences and skinfold thicknesses were measured (n = 590), and fasted lipid profile assayed (n = 325), in children from 2 ARROW trial centres in Uganda/Zimbabwe. Analyses compared randomization to long-term versus short-term versus no zidovudine from ART initiation [unadjusted; latter 2 groups receiving abacavir+lamivudine+non-nucleoside-reverse-transciptase-inhibitor (nNRTI) long-term], and nonrandomized (confounder-adjusted) receipt of nevirapine versus efavirenz. RESULTS Body circumferences and skinfold thicknesses were similar regardless of zidovudine exposure (P > 0.1), except for subscapular and supra-iliac skinfolds-for-age which were greater with long-term zidovudine (0.006 < P < 0.047). Circumferences/skinfolds were also similar with efavirenz and nevirapine (adjusted P > 0.09; 0.02 < P < 0.03 for waist/waist-hip-ratio). Total and high-density lipoprotein (HDL)-cholesterol, HDL/triglyceride-ratio (P < 0.0001) and triglycerides (P = 0.01) were lower with long-term zidovudine. Low-density lipoprotein (LDL)-cholesterol was higher with efavirenz than nevirapine (P < 0.001). Most lipids remained within normal ranges (75% cholesterol, 85% LDL and 100% triglycerides) but more on long-term zidovudine (3 NRTI) had abnormal HDL-cholesterol (88% vs. 40% short/no-zidovudine, P < 0.0001). Only 8/579(1.4%) children had clinical fat wasting (5 grade 1; 3 grade 2); 2(0.3%) had grade 1 fat accumulation. CONCLUSIONS Long-term zidovudine-based ART is associated with similar body circumferences and skinfold thicknesses to abacavir-based ART, with low rates of lipid abnormalities and clinical lipodystrophy, providing reassurance where national programs now recommend long-term zidovudine. Efavirenz and nevirapine were also similar; however, the higher LDL observed with efavirenz and lower HDL observed with zidovudine suggests that zidovudine+lamivudine+efavirenz should be investigated in future.
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Bhutia E, Hemal A, Yadav TP, Ramesh KL. Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India. Afr Health Sci 2014; 14:408-13. [PMID: 25320591 DOI: 10.4314/ahs.v14i2.17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND It is estimated that about 2.5 million people are living with HIV infection in India. Although antiretroviral drugs have been able to reduce the mortality, these drugs have serious side effects one of which is lipodystrophy syndrome. Most of the drugs used in HAART viz, protease inhibitors, stavudine and nevirapine are associated with lipodystrophy. Hence we conducted this study to assess the prevalence of lipodystrophy in HIV infected children on HAART and its associated risk factors. MATERIALS AND METHODS A cross sectional study was conducted on 80 HIV infected children aged 2-18 years of age who were on stavudine based HAART for ≥ 2 years. These children were assessed for presence of lipodystrophy, its metabolic complications and associated risk factors. RESULTS Lipodystrophy was observed in 33.7% of children with lipoatrophy being the commonest subtype followed by lipohypertrophy. Older age, increased duration of treatment and dyslipidaemia were found to be associated in patients with lipodystrophy than those without. On further multivariate analysis of independent risk factors only increased duration of treatment was significantly associated with lipodystrophy. No association was found with insulin resistance. CONCLUSION We observed that lipodystrophy is a common finding in HIV patients treated with HAART for long duration.
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