Lipodystrophy and metabolic changes in HIV-infected children on non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy

Background: Highly active antiretroviral therapy (HAART) has recently been implemented in Thailand. Its long-term effects have not been clearly evaluated. The objective of this study was to estimate the prevalence of lipodystrophy (LD) and other metabolic changes in HIV-infected children receiving H...

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Main Authors: Aurpibul L., Puthanakit T., Lee B., Mangklabruks A., Sirisanthana T., Sirisanthana V.
Format: Article
Language:English
Published: 2014
Online Access:http://www.scopus.com/inward/record.url?eid=2-s2.0-38049009326&partnerID=40&md5=16151e8e555c3be66da8c3af13f36b6d
http://www.ncbi.nlm.nih.gov/pubmed/18240864
http://cmuir.cmu.ac.th/handle/6653943832/2085
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spelling th-cmuir.6653943832-20852014-08-30T02:00:28Z Lipodystrophy and metabolic changes in HIV-infected children on non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy Aurpibul L. Puthanakit T. Lee B. Mangklabruks A. Sirisanthana T. Sirisanthana V. Background: Highly active antiretroviral therapy (HAART) has recently been implemented in Thailand. Its long-term effects have not been clearly evaluated. The objective of this study was to estimate the prevalence of lipodystrophy (LD) and other metabolic changes in HIV-infected children receiving HAART. Methods: Ninety children who began HAART (either nevirapine or efavirenz, together with lamivudine and stavudine) were prospectively followed. LD was assessed by waist-to-hip ratio and LD checklist. Hypercholesterolaemia was defined as total cholesterol >200 mg/dl and low-density lipoprotein cholesterol >130 mg/dl. Low levels of high-density lipoprotein cholesterol (HDL-c), hypertriglyceridaemia and hyperglycaemia were defined as HDL-c <40 mg/dl, triglyceride >200 mg/dl and plasma glucose >110 mg/dl, respectively. Results: The mean age at entry was 7.6 (SD 2.9) years. Fifty-three children received nevirapine- and 37 received efavirenz-based HAART. The prevalence of LD was 9%, 47% and 65% at 48, 96 and 144 weeks after HAART initiation, respectively. Patterns of LD at week 144 were central lipohypertrophy (46%), peripheral lipoatrophy (20%), and combined type (34%). A higher prevalence of LD was found among females (61% versus 39%; P=0.04) and those with more advanced disease (CDC category B or C) at baseline (73% versus 51%; P=0.04). There was no difference in prevalence of LD between the two regimens. At 144 weeks, fasting hypertriglyceridaemia was detected in 12%, hypercholesterolaemia in 11%, and increased plasma glucose in 4% of children. Low HDL-cholesterolaemia decreased from 94% at baseline to 12% at week 144(P<0.01). Conclusions: More than half of the children developed LD at 144 weeks after HAART. Dyslipidaemia occurred in 11-12% of children. © 2007 International Medical Press. 2014-08-30T02:00:28Z 2014-08-30T02:00:28Z 2007 Article 13596535 18240864 ANTHF http://www.scopus.com/inward/record.url?eid=2-s2.0-38049009326&partnerID=40&md5=16151e8e555c3be66da8c3af13f36b6d http://www.ncbi.nlm.nih.gov/pubmed/18240864 http://cmuir.cmu.ac.th/handle/6653943832/2085 English
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
language English
description Background: Highly active antiretroviral therapy (HAART) has recently been implemented in Thailand. Its long-term effects have not been clearly evaluated. The objective of this study was to estimate the prevalence of lipodystrophy (LD) and other metabolic changes in HIV-infected children receiving HAART. Methods: Ninety children who began HAART (either nevirapine or efavirenz, together with lamivudine and stavudine) were prospectively followed. LD was assessed by waist-to-hip ratio and LD checklist. Hypercholesterolaemia was defined as total cholesterol >200 mg/dl and low-density lipoprotein cholesterol >130 mg/dl. Low levels of high-density lipoprotein cholesterol (HDL-c), hypertriglyceridaemia and hyperglycaemia were defined as HDL-c <40 mg/dl, triglyceride >200 mg/dl and plasma glucose >110 mg/dl, respectively. Results: The mean age at entry was 7.6 (SD 2.9) years. Fifty-three children received nevirapine- and 37 received efavirenz-based HAART. The prevalence of LD was 9%, 47% and 65% at 48, 96 and 144 weeks after HAART initiation, respectively. Patterns of LD at week 144 were central lipohypertrophy (46%), peripheral lipoatrophy (20%), and combined type (34%). A higher prevalence of LD was found among females (61% versus 39%; P=0.04) and those with more advanced disease (CDC category B or C) at baseline (73% versus 51%; P=0.04). There was no difference in prevalence of LD between the two regimens. At 144 weeks, fasting hypertriglyceridaemia was detected in 12%, hypercholesterolaemia in 11%, and increased plasma glucose in 4% of children. Low HDL-cholesterolaemia decreased from 94% at baseline to 12% at week 144(P<0.01). Conclusions: More than half of the children developed LD at 144 weeks after HAART. Dyslipidaemia occurred in 11-12% of children. © 2007 International Medical Press.
format Article
author Aurpibul L.
Puthanakit T.
Lee B.
Mangklabruks A.
Sirisanthana T.
Sirisanthana V.
spellingShingle Aurpibul L.
Puthanakit T.
Lee B.
Mangklabruks A.
Sirisanthana T.
Sirisanthana V.
Lipodystrophy and metabolic changes in HIV-infected children on non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy
author_facet Aurpibul L.
Puthanakit T.
Lee B.
Mangklabruks A.
Sirisanthana T.
Sirisanthana V.
author_sort Aurpibul L.
title Lipodystrophy and metabolic changes in HIV-infected children on non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy
title_short Lipodystrophy and metabolic changes in HIV-infected children on non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy
title_full Lipodystrophy and metabolic changes in HIV-infected children on non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy
title_fullStr Lipodystrophy and metabolic changes in HIV-infected children on non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy
title_full_unstemmed Lipodystrophy and metabolic changes in HIV-infected children on non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy
title_sort lipodystrophy and metabolic changes in hiv-infected children on non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy
publishDate 2014
url http://www.scopus.com/inward/record.url?eid=2-s2.0-38049009326&partnerID=40&md5=16151e8e555c3be66da8c3af13f36b6d
http://www.ncbi.nlm.nih.gov/pubmed/18240864
http://cmuir.cmu.ac.th/handle/6653943832/2085
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