Related Experiment Video
Updated: Aug 6, 2026
Cellular Redox Profiling Using High-content Microscopy
Published on: May 14, 2017
Lipodystrophy in HIV-infected pediatric patients receiving protease inhibitors
Mary E Temple1, Katalin I Koranyi, Milap C Nahata
1Department of Pharmacy, Hillcrest Hospital, Mayfield Heights, OH, USA.
Insights
HIV-infected children taking protease inhibitors (PIs) may develop lipodystrophy and dyslipidemia. This study evaluated the association between PI use and these conditions in pediatric patients.
Area of Science:
- Pediatric HIV/AIDS research
- Clinical pharmacology
- Metabolic disorders
Background:
- Lipodystrophy syndrome, characterized by fat redistribution, hyperlipidemia, and insulin resistance, is a known complication in adult HIV patients on protease inhibitors (PIs).
- The full spectrum of lipodystrophy in pediatric patients receiving PIs is not well-defined.
Purpose of the Study:
- To investigate the relationship between protease inhibitor (PI) therapy and the development of lipodystrophy in children with HIV infection.
Main Methods:
- Prospective enrollment of 21 HIV-infected pediatric patients (ages 1-17) receiving PIs.
- Monthly monitoring for 36 months, recording physical exam findings (subcutaneous fat, abdominal girth) and laboratory values (lipids, glucose).
- Paired t-test used to compare baseline and follow-up data.
Main Results:
- Two of 21 pediatric patients developed lipodystrophy after initiating PI therapy.
- Abnormal total cholesterol and triglyceride levels were observed in 12 patients, particularly those on ritonavir or nelfinavir.
- Indinavir users showed increased triglycerides, but not total cholesterol; blood glucose remained stable.
Conclusions:
- Protease inhibitor (PI) use can be associated with lipodystrophy in HIV-infected children.
- Dyslipidemia, including elevated triglycerides and cholesterol, is a potential comorbidity in this pediatric population receiving PIs.
Background:
In adults with HIV infection, lipodystrophy syndrome may develop, characterized by peripheral wasting in the extremities, central obesity, hyperlipidemia, and insulin resistance. This syndrome occurs in HIV-positive pediatric patients who take protease inhibitors (PIs). However, the full characteristics of the syndrome in this population is not fully understood.
Objective:
To evaluate the association between the use of PIs and the occurrence of lipodystrophy in HIV-infected children.
Methods:
Pediatric patients attending an outpatient HIV clinic between 1994 and 2000 were prospectively enrolled. All patients were between 1 and 17 years of age and had received a PI for at least 1 month. The medical records were reviewed monthly for 3 months before PI therapy was started and then monthly for 36 months. At each evaluation, serum total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, triglycerides, and blood glucose concentrations were recorded, as well as physician-documented physical examination findings including subcutaneous fat in the arms, face, and legs, and abdominal girth. Baseline clinical and laboratory data were compared with follow-up data using a paired t-test.
Results:
Twenty-one pediatric patients received a PI. Of these, 2 developed lipodystrophy, one at 15 months and one at 18 months after PI therapy was started. Neither child had had lipodystrophy before therapy. Twelve children who were taking ritonavir or nelfinavir, including 1 who developed lipodystrophy, developed abnormally high total cholesterol and triglyceride blood concentrations. All patients receiving indinavir also experienced a substantial increase in their triglyceride concentrations at follow-up evaluations, but no significant increases in total cholesterol occurred. Blood glucose concentrations were not significantly different between baseline and follow-up examinations in our patients.
Conclusions:
Lipodystrophy may occur in some HIV-infected children receiving PIs, and dyslipidemias may also develop in some patients taking these drugs.
Related Concept Videos
01:10Retrovirus Life Cycles
01:22Lysosomal Hydrolases
01:19Inhibitors of Virion Maturation and Assembly