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Lipodystrophy in pediatric HIV

Ninad Desai1, Patricia Mullen, Mudit Mathur

  • 1Kings County Hospital Center & SUNY-Downstate College of Medicine, Brooklyn, NY 11203, USA. desain@nychhc.org

Indian Journal of Pediatrics
|June 10, 2008
PubMed

Insights

Lipodystrophy is common in children with HIV/AIDS on HAART. Bioelectric Impedance (BI) is more effective than Body Mass Index (BMI) for detecting abnormal fat accumulation in these patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Metabolic Disorders
  • Clinical Nutrition

Background:

  • Highly Active Antiretroviral Therapy (HAART) has improved outcomes for children with HIV/AIDS.
  • However, long-term HAART use is associated with metabolic complications, including lipodystrophy.
  • Accurate assessment of fat accumulation is crucial for managing these complications in pediatric populations.

Purpose of the Study:

  • To evaluate fat accumulation in children with HIV/AIDS receiving long-term HAART.
  • To compare the effectiveness of Body Mass Index (BMI) criteria and Bioelectric Impedance (BI) in identifying lipodystrophy.
  • To assess the incidence of lipodystrophy and associated hyperlipidemia.

Main Methods:

  • A prospective study involving 48 children (ages 6-15) with HIV/AIDS on HAART.
  • Lipodystrophy diagnosed clinically (truncal obesity with wasting).
  • Body fat assessed using CDC BMI curves and Omron HBF301 body fat analyzer (TBF%/height). Serum lipids measured.

Main Results:

  • Fifteen (31%) children developed lipodystrophy, with 93% also having hyperlipidemia.
  • CDC BMI curves identified only 7/15 as overweight or at risk.
  • Bioelectric Impedance (TBF/Ht ≥30%) showed 85% sensitivity and 88% specificity for lipodystrophy.

Conclusions:

  • Lipodystrophy is a significant concern for children with HIV/AIDS on HAART.
  • Bioelectric Impedance (BI) is superior to BMI for detecting abnormal fat accumulation in this cohort.
  • Routine use of BI is recommended for assessing children with HIV/AIDS on HAART.
Abstract

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