Long-term body composition and metabolic changes in HIV-infected children switched from stavudine to tenofovir and from protease inhibitors to efavirenz

Fabiano, Valentina; Giacomet, Vania; Viganò, Alessandra; Bedogni, Giorgio; Stucchi, Sara; Cococcioni, Lucia; Mora, Stefano; Zuccotti, Gian Vincenzo

doi:10.1007/s00431-013-2018-3

Cited by 12 publications

(18 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This same cohort was reevaluated again 8 years after the treatment switch and showed no frankly pathologic abnormalities of body composition. 83 Recommended treatment strategies include lifestyle changes such as a calorically appropriate low-fat diet; exercise (especially strength training); and smoking cessation, if applicable, to decrease future cardiovascular risk. Proposed treatments include metformin and thiazolidinediones, but data regarding their efficacy are lacking in children.…”

Section: Managementmentioning

confidence: 99%

Endocrinopathies in Children Infected with Human Immunodeficiency Virus

Loomba-Albrecht¹,

Bregman²,

Chantry³

2014

Endocrinology and Metabolism Clinics of North America

View full text Add to dashboard Cite

Section: Managementmentioning

confidence: 99%

Endocrinopathies in Children Infected with Human Immunodeficiency Virus

Loomba-Albrecht¹,

Bregman²,

Chantry³

2014

Endocrinology and Metabolism Clinics of North America

View full text Add to dashboard Cite

“…Among the factors that may be implicated in atherosclerotic disease, dyslipidemia and inflammation are the most important [ 1 – 5 ]. The abnormalities in carbohydrate metabolism are evident [ 2 – 5 ], but less common complications [ 6 ], although other studies have not demonstrated any impairment [ 7 , 8 ]. The occurrence of these cardiovascular risk factors in childhood and adolescence has been associated with intima-media thickening of the carotid artery (IMTc) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Dyslipidemia, chronic inflammation, and subclinical atherosclerosis in children and adolescents infected with HIV: The PositHIVe Health Study

et al. 2018

View full text Add to dashboard Cite

HIV-infected children and adolescents may be at risk for cardiovascular disease due to chronic inflammation and exacerbation of risk factors. The aim of this study was as follows: 1) compare cardiovascular risk factors, chronic inflammation, and carotid intima-media thickness (IMTc) between the HIV and control groups; 2) determine the association of HIV and antiretroviral (ART) regimens with cardiovascular risk factors, chronic inflammation, and IMTc; and 3) identify variables associated with elevated IMTc. Cross-sectional analysis of 130 children and adolescents, 8–15 years of age, divided into HIV-infected (n = 65) and healthy control (n = 65) participants. Body fat, blood pressure, glycemia, insulin, and glycated hemoglobin, total cholesterol and fractions (LDL-C and HDL-C), triglycerides, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), and the IMTc were measured. The results showed HIV-infected children and adolescents had higher levels of glycemia (87.9 vs. 75.9 mg.dL−1, p< 0.001), LDL-c (94.7 vs. 79.5 mg.dL−1, p = 0.010), triglycerides (101.2 vs. 61.6 mg.dL−1, p< 0.001), CRP (1.6 vs. 1.0 mg.L−1, p = 0.007), IL-6 (1.42 vs. 0.01 pg.mL−1, p< 0.001), TNF-α (0.49 vs. 0.01 pg.mL−1, p< 0.001), mean IMTc (0.526 vs. 0.499 mm, p = 0.009), and lower HDL-c (53.7 vs. 69.4 mg.dL−1, p< 0.001) compared to controls. Systolic blood pressure (β = 0.006, p = 0.004) and TNF-α (β = −0.033, p = 0.029) accounted for 16% of IMTc variability in HIV-infected children and adolescents. In patients using protease inhibitors-based ART, male gender (β = −0.186, p = 0.008), trunk body fat (β = −0.011, p = 0.006), glucose (β = 0.005, p = 0.046), and IL-6 (β = 0.017, p = 0.039) accounted for 28% of IMTc variability. HIV-infected children and adolescents may be at risk for premature atherosclerosis due to chronic inflammation and dyslipidemia. Interventions with the potential to improve lipid profile, mitigate inflammation, and reduce cardiovascular risk are needed.

show abstract

“…Reversibility of fat loss after ceasing of stavudine treatment is still debated [ 25 , 26 ]. In our cohort a subgroup of 26 children switched from stavudine to another NRTI (predominantly abacavir) and had DEXA assessments before as well as after this switch.…”

Section: Resultsmentioning

confidence: 99%

Long-Term Changes of Subcutaneous Fat Mass in HIV-Infected Children on Antiretroviral Therapy: A Retrospective Analysis of Longitudinal Data from Two Pediatric HIV-Cohorts

et al. 2015

View full text Add to dashboard Cite

ObjectiveLongitudinal studies objectively evaluating changes in regional fat distribution of HIV-infected children assessed by whole body dual energy X-ray absorptiometry (DEXA) are scarce, whilst this long-term effect of HIV and antiretroviral therapy (cART) is an important issue in infected children in need for lifelong treatment.MethodsWe assessed regional fat distribution over time, measured with sequential DEXA-scans in HIV-infected children on cART in cohorts from South Africa (SA) and the Netherlands (NL), and in healthy controls (SA). Limb and trunk fat Z-scores were calculated with the lambda-mu-sigma (LMS) method. Multivariable linear regression models with mixed effects were used to investigate the effect of cART compounds on body fat distribution over time.ResultsIn total, 218 children underwent 445 DEXA assessments with a median follow-up of 3.5 years. Fat mass in all limbs was decreased in HIV-infected children compared to controls (arm fat Z-score: coefficient -0.4813; P = 0.006, leg fat Z-score: coefficient -0.4345; P = 0.013). In the HIV-infected group, stavudine treatment was associated with lower subcutaneous fat mass (arm fat Z-score: coefficient -0.5838; P = 0.001), with an additional cumulative exposure effect (arm fat Z-score: coefficient -0.0867; P = 0.003).ConclusionsOur study shows that subcutaneous fat loss is still prevalent in HIV-infected children on cART, and is strongly associated with cumulative stavudine exposure. These results underline the need for early detection of subcutaneous fat loss and alternative treatment options for HIV-infected children globally.

show abstract

Long-term body composition and metabolic changes in HIV-infected children switched from stavudine to tenofovir and from protease inhibitors to efavirenz

Abstract: patients, after switching from d4T to TDF and from PI to EFV, show most of the changes in anthropometry and body composition associated with normal growth and no frankly pathological change in metabolic parameters.

Cited by 12 publications

References 37 publications

Endocrinopathies in Children Infected with Human Immunodeficiency Virus

Endocrinopathies in Children Infected with Human Immunodeficiency Virus

Dyslipidemia, chronic inflammation, and subclinical atherosclerosis in children and adolescents infected with HIV: The PositHIVe Health Study

Long-Term Changes of Subcutaneous Fat Mass in HIV-Infected Children on Antiretroviral Therapy: A Retrospective Analysis of Longitudinal Data from Two Pediatric HIV-Cohorts

Contact Info

Product

Resources

About