Prevalence of dyslipidemia and lipodystrophy in HIV infected children treated with highly active antiretroviral therapy. Instituto Nacional de Salud del Niño, 2007

Abstract

Introduction: Due to advances in HIV pathogenesis and use of antiretroviral therapy, long term adverse effects have received greater importance. Metabolic alterations and body fat redistribution are described between the most frequent in paediatric population

Objectives: To determine the prevalence of dyslipidemia and lipodystrophy, and to assess the associated risk factors frequency of presentation in HIV infected children treated with highly active antiretroviral therapy (HAART) at Instituto Nacional de Salud del Niño.

Methodology: Descriptive, cross sectional, prospective, observational study. Participants were children who were undergoing HAART attending paediatric Infectology office, with minimum six months length. Clinical history was reviewed to brief data about treatment, antecedents and laboratory values (lipid profile, CD4 cell count and HIV viral load). Anamnesis and physical examination were made at only one visit, the presence or absence of fat redistribution clinical signs was recorded for all children. Groups were compared to determine differences between age, sex, clinical class and immunological staging, HIV viral load and length of antirretroviral treatment.

Results: A total of 38 children with ages between 1 and 15 years were included. Prevalence of dyslipidemia and lipodystrophy was 52.63%. 65.79% of children presented dislipidemia alone: 1/38 (2.63%) for hypercholesterolemia, 20/38 (52.63%) for hypertriglyceridemia and 4/38 (10.53%) for hypercholesterolemia and hypertriglyceridemia. 63.16% of children presented lipodystrophy alone: 3/38 (7.89%) for peripheral lipoatrophy, 8/38 (21.05%) for central lipohypertrophy and 13/38 (34.21%) for combined lipodystrophy. Frequency of dislipidemia was greater in male gender children (p=0.05) and frequency of lipodystrophy was greater in children with detectable HIV viral load (p=0.02).

Conclusions: Prevalence of dyslipidemia and lipodystrophy was 52.63% in our population. Hypertriglyceridemia and combined lipodystrophy were the most frequent alterations. Dislypidemia was more frequent in male gender children and lipodystrophy in children with detectable HIV viral load.