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HIV--associated lipodystrophy in children

Jens C Krause1, Mary P Toye, Barbara W Stechenberg

  • 1Baystate Children's Hospital, Tufts University School of Medicine, Department of Pediatrics, 759 Chestnut Street, Springfield, MA 01199, USA.

Pediatric Endocrinology Reviews : PER
|December 22, 2005
PubMed

Insights

Highly active antiretroviral therapy (HAART) can cause lipodystrophy (LD) in children with HIV. This review explores the roles of various hormones and cytokines in LD

Area of Science:

  • Endocrinology
  • Immunology
  • Pediatric HIV

Background:

  • Lipodystrophy (LD) is a complication of highly active antiretroviral therapy (HAART) in HIV-infected children.
  • LD presents with lipohypertrophy, lipoatrophy, hyperlipidemia, and insulin resistance.

Purpose of the Study:

  • To review the roles of leptin, adiponectin, growth hormone axis, glucocorticoids, SREBP-1c, TNF-alpha, IL-6, IL-18, IFN-alpha, tPA, and PAI-1 in the pathophysiology of LD.
  • To elucidate the complex mechanisms underlying HAART-induced lipodystrophy in pediatric HIV.

Main Methods:

  • Literature review and data summarization.
  • Analysis of hormonal and cytokine profiles in pediatric LD.

Main Results:

  • Adiponectin levels are typically decreased, while leptin levels are increased in LD.
  • Glucocorticoids play a role in LD, despite normal systemic cortisol levels.
  • Growth hormone resistance in LD requires further investigation.

Conclusions:

  • Multiple factors, including hormones and cytokines, contribute to the pathophysiology of LD in HAART-treated children.
  • Further research is needed to clarify the causal relationships between specific biomarkers and LD development.

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