Body Fat Changes and Lipodystrophy in HIV-infected Children

Dzwonek, Agnieszka B.; Lawson, Margaret; Cole, Tim J.; Novelli, Vas

doi:10.1097/01.qai.0000230523.94588.85

Cited by 28 publications

(22 citation statements)

References 12 publications

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“…This study is an extension of a previously published cross-sectional analysis and confirmed our earlier findings that although physical features of lipodystrophy were seen in only 5% of patients in our cohort, children with no clinical evidence of lipodystrophy had altered body fat distribution [9]. Up to date, two longitudinal studies in HIV-infected children estimated that 25% -54% have changes in body fat distribution [10,11].…”

Section: Discussionsupporting

confidence: 76%

“…The mean value of the three measurements was used in the analysis. Skinfold and circumference measurements were converted to ageand sex-adjusted z-scores (the distance of the value from the age-and sex-appropriate mean) using Dutch reference data and a SPSS programme developed at the Institute of Child Health, UCL, described previously [9,14].…”

Section: Anthropometric Measurementsmentioning

confidence: 99%

“…Some studies have shown that ethnicity, clinical condition, duration of HIV infection, nucleoside reverse tran-scriptase inhibitor (NRTI) and protease inhibitor (PI) treatment were associated with lipodystrophy [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…The lipodystrophy syndrome has been mostly studied via cross-sectional studies [2][3][4][5][6]8,9]. Determination of the prevalence of lipodystrophy has been complicated by the lack of an objective case definition for use in children.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Antiretroviral Therapy (ART) on Body Composition and Clinical Markers of Lipodystrophy in HIV-Infected Children Assessed in Follow-Up Study

Dzwonek¹,

Novelli²,

Smith³

et al. 2012

WJA

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Objectives: Antiretroviral therapy (ART) has been associated with lipodystrophy in children. We evaluated changes in various anthropometric measurements for the assessment of lipodystrophy and assessed whether there was an association with use of protease inhibitors (PI), non-PI containing ART and/or stavudine (d4T). Methods: Eighty-five HIV-infected children attending the HIV clinic at Great Ormond Street Hospital (GOSH) were included. The average follow-up was 8.4 months (range 3 -12 months). Body fat redistribution was assessed by anthropometric measurements including skinfold thickness and circumferences of upper and lower limbs. Measurements were converted to age-and sex-adjusted z-scores through development stages including puberty. Results: Sixty children had taken ART; 37 received PI-containing; 38 received d4T; 25 had never been treated. In the studied population, clinically important changes with decreases in biceps (BSF), subscapular skinfolds and total body fat (4SFT) over period of 12 months were observed. Some increase was noticed in triceps skinfolds (TSF). Limbs circumferences remained at the same level. Further we looked at 4 months basis changes in anthropometric measurements stratified by baseline ART. Generally z-scores of anthropometric measurements were lower in therapy naive children when compared to ART groups. PI-based ART regimens resulted in significant increases in BSF with a trend towards increases in TSF, suprailiac and 4SFT. Mid-arm and thigh circumferences were higher in PI compared to naive group. Similarly, significant changes in BSF z-scores were associated with d4T use. Increases were seen in TSF and mid-arm circumference and decreases were observed in subscapular skinfolds and calf circumference z-scores. Conclusions: Body fat redistribution in HIV-infected children with sub-clinical lipodystrophy could be detected by anthropometric measurements, particularly when PI or d4T is included in ART. Over time, changes with increase in arm and trunk fat, and no change or decrease in leg fat were more pronounced among ART-receiving children.

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Section: Discussionsupporting

confidence: 76%

Section: Anthropometric Measurementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of Antiretroviral Therapy (ART) on Body Composition and Clinical Markers of Lipodystrophy in HIV-Infected Children Assessed in Follow-Up Study

Dzwonek¹,

Novelli²,

Smith³

et al. 2012

WJA

Self Cite

View full text Add to dashboard Cite

show abstract

“…We assessed central fat accumulation by using the following measurements: waist circumference, waist and hip ratio and subscapular skinfold thickness [15]. Peripheral fat distribution (fat accumulation or wasting) was assessed by measuring upper and lower limb circumferences (mid-upper arm, calf and thigh) and also by assessing skinfold thickness (triceps, biceps, and suprailiac) [16].…”

Section: Anthropometric Measurementsmentioning

confidence: 99%