Metabolic abnormalities in human immunodeficiency virus-infected children: Two-year follow-up

Author Department

Pediatrics

Document Type

Article, Peer-reviewed

Publication Date

4-1-2009

Abstract

BACKGROUND: HIV-associated lipodystrophy (LD) manifests with fat maldistribution, dyslipidemia, and insulin resistance in some HIV-infected children on antiretroviral therapy. AIM: To assess whether lipid abnormalities in patients with HIV are stable over time. PATIENTS: The perinatally HIV-infected cohort at a medium-sized urban US teaching hospital. METHODS: This prospective, observational study consisted of five visits (at entry and 3, 6, 24, and 30 months after entry) during which fasting venous blood samples were drawn for HIV-1 RNA, CD4 lymphocytes, lipid profile, free fatty acids (FFA), glucose, insulin, and adiponectin. IGF-I/IGFBP-3 levels were measured at the first and fifth visits. RESULTS: Of 36 study participants, seven were lipodystrophic, and 30 patients completed all five study visits. LDL-cholesterol, total cholesterol (TC), triglycerides (TG), and FFA levels were significantly higher in patients taking protease inhibitors (PIs). Patients with LD had higher TC and TG levels (both p < 0.05), and higher FFA (p = 0.0532). Adiponectin levels did not differ between PI/non-PI and LD/non-LD groups. HDL-cholesterol seemed to decrease, and FFA to increase over time. All IGF-I and all but one IGFBP-3 level were within normal range for age and Tanner stage. CONCLUSION: Dyslipidemia remained relatively constant over our study period. Adiponectin was not useful as a marker of LD in our population.

Publication ISSN

0884-8734

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