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Metabolic disorders in vertically HIV-infected children: future adults at risk for cardiovascular disease

Marta Dapena1, Beatriz Jiménez, Antoni Noguera-Julian

  • 1Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron -- Universitat Autònoma de Barcelona, Barcelona, Spain.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|August 11, 2012
PubMed

Insights

Metabolic disorders are common in HIV-infected children, with nearly 20% experiencing insulin resistance. These conditions, including abnormal fat distribution, are linked to antiretroviral therapy and co-infections, highlighting the need for management strategies.

Area of Science:

  • Pediatric Endocrinology
  • Infectious Diseases
  • Cardiovascular Risk Management

Background:

  • Metabolic disorders are prevalent in children with HIV but lack standardized diagnostic and management criteria.
  • Existing research on pediatric HIV metabolic complications shows heterogeneous results across different settings and parameters.

Purpose of the Study:

  • To determine the prevalence of metabolic disorders in a Spanish pediatric HIV cohort (CoRISpe).
  • To identify risk factors associated with these metabolic disorders in HIV-infected children and adolescents.

Main Methods:

  • A cross-sectional study was conducted on vertically HIV-infected children and adolescents across three Spanish referral centers.
  • Collected metabolic data included fasting lipids, glucose, insulin, and thyroid hormone levels.
  • Fat distribution was assessed clinically by expert physicians.

Main Results:

  • 157 patients were analyzed; nearly 20% had insulin resistance, associated with hepatitis C, stavudine use, and hypertriglyceridemia.
  • Hypercholesterolemia (23.9%) and hypertriglyceridemia (24.8%) were linked to protease inhibitor use.
  • Abnormal fat distribution (40.5%), including lipoatrophy and lipohypertrophy, was significantly associated with prior stavudine exposure.

Conclusions:

  • Metabolic disorders represent a significant health issue in the studied pediatric HIV population.
  • There is a critical need for global strategies and consensus guidelines to mitigate cardiovascular risk in these patients.
Abstract

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