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

Jens C Krause1, Mary P Toye, Donna J Fisher

  • 1Division of Pediatric Infectious Diseases, Vanderbilt Children's Hospital, Nashville, TN, USA.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|June 27, 2009
PubMed

Insights

Lipid abnormalities in children with HIV and lipodystrophy remained stable over 30 months. Adiponectin levels did not effectively indicate lipodystrophy in this HIV-infected pediatric cohort.

Area of Science:

  • Pediatric Endocrinology
  • Infectious Diseases
  • Metabolic Disorders

Background:

  • HIV-associated lipodystrophy (LD) presents with fat maldistribution, dyslipidemia, and insulin resistance in children on antiretroviral therapy.
  • Understanding the long-term stability of these metabolic abnormalities is crucial for patient management.

Purpose of the Study:

  • To evaluate the stability of lipid abnormalities in children with HIV over a 30-month period.
  • To investigate potential biomarkers for lipodystrophy in this population.

Main Methods:

  • Prospective, observational study of a perinatally HIV-infected cohort.
  • Five study visits over 30 months, collecting blood for HIV-1 RNA, CD4 counts, lipid profiles, glucose, insulin, adiponectin, and IGF-I/IGFBP-3.
  • Analysis compared lipid levels between patients on protease inhibitors (PIs) versus non-PIs, and between those with and without lipodystrophy (LD).

Main Results:

  • Patients on PIs had significantly higher LDL-cholesterol, total cholesterol (TC), triglycerides (TG), and free fatty acids (FFA).
  • Patients with LD exhibited higher TC, TG, and FFA levels.
  • HDL-cholesterol showed a decreasing trend, while FFA increased over time; adiponectin levels did not differ significantly between groups.

Conclusions:

  • Dyslipidemia in children with HIV remained relatively stable throughout the 30-month study period.
  • Adiponectin was not identified as a reliable marker for lipodystrophy in this pediatric cohort.
Abstract

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