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Metabolic abnormalities in human immunodeficiency virus-infected children: Two-year follow-up
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  • Maripat Toye, RN MS, Baystate Health
  • Jens Krause, MD, Baystate Health
  • Donna Fisher, MD, Baystate Health
  • Barbara W Stechenberg, MD, Baystate Health
  • Edward Reiter, MD, Baystate Health
  • Holley Allen, MD, Baystate Health
Document Type
Article, Peer-reviewed
Publication Date
BACKGROUND: HIV-associated lipodystrophy (LD) manifests with fat maldistribution, dyslipidemia, and insulin resistance in some HIV-infected children on antiretroviral therapy. AIM: To assess whether lipid abnormalities in patients with HIV are stable over time. PATIENTS: The perinatally HIV-infected cohort at a medium-sized urban US teaching hospital. METHODS: This prospective, observational study consisted of five visits (at entry and 3, 6, 24, and 30 months after entry) during which fasting venous blood samples were drawn for HIV-1 RNA, CD4 lymphocytes, lipid profile, free fatty acids (FFA), glucose, insulin, and adiponectin. IGF-I/IGFBP-3 levels were measured at the first and fifth visits. RESULTS: Of 36 study participants, seven were lipodystrophic, and 30 patients completed all five study visits. LDL-cholesterol, total cholesterol (TC), triglycerides (TG), and FFA levels were significantly higher in patients taking protease inhibitors (PIs). Patients with LD had higher TC and TG levels (both p < 0.05), and higher FFA (p = 0.0532). Adiponectin levels did not differ between PI/non-PI and LD/non-LD groups. HDL-cholesterol seemed to decrease, and FFA to increase over time. All IGF-I and all but one IGFBP-3 level were within normal range for age and Tanner stage. CONCLUSION: Dyslipidemia remained relatively constant over our study period. Adiponectin was not useful as a marker of LD in our population.
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Citation Information
Krause JC, Toye MP, Fisher DJ, Stechenberg BW, Reiter EO, Allen HF. Metabolic abnormalities in human immunodeficiency virus-infected children: Two-year follow-up J Pediatr Endocrinol Metab 2009 Apr;22(4):345-51.