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Lipodystrophy and metabolic complications of highly active antiretroviral therapy

Ankit Parakh1, Anand Prakash Dubey, Ajay Kumar

  • 1Department of Pediatrics, Maulana Azad Medical College and Associated Hospitals, New Delhi, India. ankitparakh102@rediffmail.com

Indian Journal of Pediatrics
|November 13, 2009
PubMed

Insights

Metabolic abnormalities and lipodystrophy are emerging complications in Indian children receiving first-line highly active antiretroviral therapy (HAART). Close follow-up is crucial for managing these potential side effects.

Area of Science:

  • Pediatric infectious diseases
  • Pharmacology and toxicology
  • Metabolic disorders

Background:

  • Highly active antiretroviral therapy (HAART) is the standard of care for HIV-infected children.
  • Understanding the metabolic toxicities of first-line HAART regimens is essential for long-term patient management.
  • Body fat redistribution (lipodystrophy) is a known concern with antiretroviral drugs.

Purpose of the Study:

  • To evaluate metabolic drug toxicities associated with WHO-recommended generic HAART in children.
  • To determine the prevalence of body fat redistribution (lipoatrophy and lipohypertrophy) in this population.
  • To identify risk factors contributing to these adverse effects.

Main Methods:

  • A cross-sectional observational study involving 52 HIV-infected children (25 on HAART, 27 controls).
  • Assessment included sociodemographic, clinical, and immunological data.
  • Physical examination for lipodystrophy, and laboratory tests for liver function, blood sugar, lipids, amylase, lactate, pH, and bicarbonate.

Main Results:

  • Children on HAART (stavudine/zidovudine-based) showed lower weight-for-age and BMI, but similar height-for-age compared to controls.
  • Two cases of peripheral lipoatrophy and four cases of hypercholesterolemia were observed in the HAART group.
  • Asymptomatic mild hyperlactatemia occurred in four children; no hyperglycemia or liver impairment was noted.

Conclusions:

  • Metabolic abnormalities and lipodystrophy are emerging complications of HAART in Indian children.
  • These findings highlight the need for vigilant monitoring and follow-up.
  • Larger, longitudinal studies are recommended to further elucidate these complications.
Abstract

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