Abnormal body-fat distribution in HIV-1-infected children on antiretrovirals

Babl, Franz E; Regan, Anne Marie; Pelton, Stephen I.

doi:10.1016/s0140-6736(98)05754-7

Cited by 54 publications

(27 citation statements)

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“…Since these changes start appearing within 1 year of treatment and become more apparent in the 2 nd year of treatment (8,10) hence we included those patients who were on treatment for more than 2 years. Most of the published studies have patients treated with PI based HAART and has reported 1-43% prevalence of lipodystrophy (2,3,6,(13)(14)(15)(16)(17)(18)(19)(20) . Our study is one of those very few studies conducted on stavudine based HAART especially in pediatric age group.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism responsible for this syndrome remains unclear. It has been proposed that antiretroviral drugs such as protease inhibitors (PI) and/ or nucleoside analogues (stavudine) could contribute to the development of such clinical and metabolic abnormalities (2,6,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(28)(29)(30)(31)(32)(33)(34)(35) . Various risk factors have been found to be associated with the development of lipodystrophy like older age and increasing duration of treatment (22,33,34,35) .…”

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confidence: 99%

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Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India

Bhutia¹,

Hemal²,

Yadav³

et al. 2014

Afr H. Sci.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India

Bhutia¹,

Hemal²,

Yadav³

et al. 2014

Afr H. Sci.

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“…9 -11 In general, children have a more difficult time maintaining viral suppression because of many factors, including frequent nonadherence and less availability of antiretrovirals in palatable forms. Recent reports underline that children experience long-term metabolic abnormalities in the same manner that adults do, [12][13][14][15][16][17] and perhaps these consequences are even more worrisome in children secondary to long-term expected survival. We report here the results of the first openlabel PI-switch study in HIV-infected children.…”

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confidence: 99%

Impact of Protease Inhibitor Substitution With Efavirenz in HIV-Infected Children: Results of the First Pediatric Switch Study

McComsey

Bhumbra

et al. 2003

Pediatrics

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ABSTRACT. Objective. Simplification of antiretroviral regimen in human immunodeficiency virus (HIV)-infected children has not yet been investigated. In general, children have a more difficult time maintaining viral suppression because of many factors, including frequent nonadherence and less availability of antiretrovirals in palatable forms. In addition, many serious metabolic complications have emerged in HIV-infected adults and are believed to be attributable to antiretroviral therapy. Some of these complications-hypercholesterolemia, hypertriglyceridemia, and insulin resistance-are believed to be the result of the use of protease inhibitor (PI) therapy, whereas the cause of others, such as lipodystrophy, remains undetermined. Recent reports underline that children experience long-term metabolic abnormalities in the same manner that adults do, and perhaps these consequences are even more worrisome in children secondary to long-term expected survival. We report here the results of the first open-label PI-switch study in HIV-infected children.Methods. Seventeen children, 24 to 160 months of age (median: 120), were enrolled into the study. All were receiving a stable PI-containing antiretroviral regimen that containing 2 to 3 nucleoside analogue reverse transcriptase inhibitors (NRTIs) in addition to 1 to 2 PIs for a median duration of 21 months (range: 5-50) before study entry. All children had HIV-1 RNA <400 copies/mL at screening; their baseline plasma HIV-1 RNA level had been <400 copies/mL for a median of 13 months (range: 4 -55) before study entry. All patients were naïve to nonnucleoside reverse transcriptase inhibitor therapy. Their protease inhibitor(s) was switched to efavirenz while their NRTI therapy was maintained.Results. All children were heavily pretreated; 88% of the patients had previous NRTIs, and 41% had previous PI use. The most common PI at study entry was nelfinavir (47%), followed by ritonavir (29%), then amprenavir (18%); only 1 was on saquinavir/ritonavir. At study entry, the duration of previous antiretroviral therapy was between 21 and 123 months (median: 88). All patients completed the 48-week study. No acquired immunodeficiency syndrome-defining events occurred. There were no rashes and no changes in liver transaminases. Mild, transient insomnia and dizziness each occurred in 1 child. Two other subjects (6 and 8 years old) experienced unusual vivid dreams, mostly pleasant, which decreased in intensity and frequency after the first 12 weeks of the study. One subject, a 10-year-old girl, had an episode of generalized seizure at week 6; study drugs were not interrupted, and seizure never recurred. The patient had a strong family history of epilepsy, although she had never experienced previous seizures. No anticonvulsants were given. Sixteen of 17 patients had HIV-1 RNA levels of <50 copies/mL (1 HIV-1 RNA was 61 copies/mL) at week 48. The mean CD4% remained stable initially from a mean of 35.1% (؎2.8%) at baseline to 36.8% (؎5%) at week 24, but increased to 38% (؎6%) at week 48. Fastin...

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“…FR was found among 45.9% of children and metabolic abnormalities in 35.9% of children. Various studies from both developing and developed countries have shown the prevalence of LDS to be varying from 23% to 56% [2][3][4] and that of FR was between 25% and 42% .This wide-ranging variation in the prevalence of LDS and FR could be due to lack of consensus in the definition of the LDS or FR, heterogeneity of the study group indicating ethnic predisposition, variable duration of ART exposure before the assessment, varying duration of ART exposure at the time of analysis and many subjects receiving multiple ART regimens before assessment. However, metabolic abnormalities were found in 34% to 42% of children which is comparable to our study.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] This wide variation in the prevalence of the LDS could be due to lack of consensus on the definition of LDS, ethnic, sociocultural and nutritional variation and variable number and duration of ART regimen exposure among the study subjects from the different parts of the world. The normal dynamic childhood alteration in the body fat composition pose a greater challenge in the assessment of ART-associated FR.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictors for lipodystrophy syndrome among HIV infected children on anti-retroviral therapy

Sanjeeva

Pavithra

Sukanya

et al. 2016

Int J Contemp Pediatr

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Abnormal body-fat distribution in HIV-1-infected children on antiretrovirals

Cited by 54 publications

References 4 publications

Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India

Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India

Impact of Protease Inhibitor Substitution With Efavirenz in HIV-Infected Children: Results of the First Pediatric Switch Study

Prevalence and predictors for lipodystrophy syndrome among HIV infected children on anti-retroviral therapy

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