Lipodystrophy syndrome and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy

Abstract

Objective: To describe lipid profile, body shape changes, and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy. Methods:We investigated 43 children and adolescents being treated with this therapy at the outpatient clinic of pediatric infectious diseases of Instituto Fernandes Figueira/Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. Values of total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides were determined. We also performed glucose tolerance test and analyzed body fat distribution, nutritional status, dietary intake, and family history of cardiovascular risk. The statistical analysis was performed using Student's t test. Significance level of pvalue was lower than 0.05. Results:We found lipid abnormality in 88.3% and body shape change in 13.9% of the cases. Nutritional status was adequate (81.3%) in most of the study population. Cholesterol intake in children older than 9 years was above the recommended value. Conclusion:Prevalence of dyslipidemia and, therefore, risk for cardiovascular diseases were high during the use of highly active antiretroviral therapy.J Pediatr (Rio J). 2010;86(1):27-32: Lipodystrophy, HIV, cardiovascular diseases, children, adolescents. ResumoObjetivo: Descrever o perfil lipídico, alterações da conformação corporal e fatores de risco cardiovasculares em crianças e adolescentes infectados pelo HIV/AIDS, tratados com terapia antirretroviral de alta potência. Métodos:Foram estudadas 43 crianças e adolescentes em uso dessa terapia atendidas no ambulatório de doenças infecciosas em Pediatria do Instituto Fernandes Figueira/Fundação Oswaldo Cruz, Rio de Janeiro (RJ). Foram realizadas dosagens de colesterol total, lipoproteína de alta densidade, lipoproteína de baixa densidade, triglicerídeos, teste de tolerância à glicose e avaliada a distribuição de gordura corporal, estado nutricional, ingestão dietética e história familiar de risco cardiovascular. As análises estatísticas foram realizadas com o teste t de Student. O nível de significância estatístico do p foi menor que 0,05.Resultados: Observou-se alteração lipídica em 88,3% e de conformação corporal em 13,9% dos casos. O estado nutricional foi adequado na maioria (81,3%) da população do estudo. A ingestão de colesterol em crianças com mais de 9 anos foi acima do recomendado. Conclusão:A prevalência de dislipidemia e, consequentemente, o risco para doenças cardiovasculares foram altos durante o uso de terapia antirretroviral de alta potência.

Satisfação corporal e características de lipodistrofia em crianças e adolescentes com HIV/AIDS em uso de terapia antirretroviral de alta potência

“…These findings are similar to those reported by Werner, Fonseca and Chaves (24) and Aldrovandi et al (25) Altered glucose metabolism, which can be affected by coinfection with the hepatitis C virus, use of protease inhibitors, presence of lipodystrophy, and a family history of diabetes mellitus, among other factors, is more common in adults (26) .…”

“…Regarding nutritional status, 74% of subjects assessed in the present study had BMIs within normal range, a rate similar to that reported by Werner, Fonseca and Chaves (24) , in a crosssectional survey of 43 HIV-positive Brazilian children and adolescents seen at an outpatient clinic. Conversely, Centeville et al (27) reported lower rates of normal weight in a retrospective longitudinal study of 119 Brazilian children living with HIV.…”

Las deficiencias más significativas de macro y micro nutrientes en adolescentes que viven con el VIH/sida en terapia anti-retroviral

“…The low intake of total fibers is consonant to the results by Werner et al (13), where inadequate intake of this nutrient prevailed in subjects above 9 years of age. This fact may contribute to the concentration increase of serum cholesterol, because fibers have the capacity of binding to some substances, such as cholesterol, in the bowel, decreasing its absorption.…”

“…A study conducted by Leitte (18) in Rio de Janeiro with HIV-infected adults noted that the subjects' diets were with high sodium content, with a percentage of 82% above recommendations, thus inadequate for the primary prevention of cardiovascular diseases. Goldstein (27) mentions that arterial hypertension is dependent on nutritional factors such as excessive sodium intake.…”

Nível De Atividade Física E Síndrome Lipodistrófica Em Pacientes Com Hiv/Aids

“…No ano de 2012, 313 mil pacientes faziam uso da TARV 3 . Um ponto negativo da TARV é a indução da Síndrome Lipodistrófica, ou seja, alterações na distribuição de gordura corporal e anormalidades metabólicas, que elevam o risco para o desenvolvimento de doenças cardiovasculares 4,5 .…”