Abstract:Introduction: HIV-infected children and adolescents treated with highly active antiretroviral therapy (HAART) regimens that include a protease inhibitor (PI) can show significant improvements in clinical outcomes, nutritional status and quality of life. The study aimed to report nutritional and metabolic alterations for pediatric patients continuously exposed to HAART and for healthy controls for up to 1 year. Methods: Clinical, anthropometric, lipid profile and food intake data were collected prospectively ov… Show more
“…The differences seen for stunting prevalence and body fat percentage according to HAART regimens might be correlated and derived from growth deviations. However, it is important to point out that some authors have not considered bioelectrical impedance analysis a good parameter for assessing body fat abnormalities in the paediatric population (7,9) . Contri et al (7) evaluated patients aged 3-17 years under HAART and found that both groups (receiving and not receiving PI therapy) had similar and unchanged body composition.…”
Section: ‡Whomentioning
confidence: 99%
“…Despite the fact that bioelectrical impedance analysis has been used to assess body composition in HIVinfected children, it is difficult to analyse the results due to the lack of standards for children. Besides that, bioelectrical impedance analysis measures only whole-body fat and lean body mass, which does not allow the identification of body fat distribution abnormalities (9) . It is important to emphasize that alterations associated with antiretroviral therapy are likely a result of complex interactions between HIV infection, specific antiretroviral agents, age, gender, as well as host genetic and lifestyle factors (30) .…”
Section: ‡Whomentioning
confidence: 99%
“…Although beneficial to the prognosis of HIV infection, exposure to HAART has been associated with disturbances in the nutritional status of this population group (5)(6)(7)(8)(9) , including body fat distribution abnormalities, which may represent an increased risk for premature CVD (5,8) . HAART also does not seem to fully reverse the effects of HIV/AIDS on children's growth (10) .…”
Objective: Although the benefits of highly active antiretroviral therapy (HAART) have been documented, it is thought to be associated to disturbances in nutritional status. These disturbances may occur early in life and are poorly understood. The present study aimed to investigate the relationship between anthropometric parameters and body composition of perinatally HIV-infected children and adolescents under HAART, according to use and non-use of protease inhibitors. Design: Cross-sectional study undertaken between August and December 2007. Demographic, socio-economic, clinical and anthropometric data were collected from the patients. The χ 2 test, Wilcoxon rank sum test (Mann-Whitney) and t test were used to compare the following variables between users and non-users of protease inhibitors: age, gender, per capita income, HAART exposure, antiretroviral therapy adopted in the last three years, CD4 count, viral load, pubertal stage, nutritional status (BMI-for-age, height-for-age, waist and neck circumferences, triceps skinfold thickness, body fat percentage, upper-arm fat area and upper-arm muscle area). Setting: An HIV/AIDS out-patient clinic, São Paulo, Brazil. Subjects: One hundred and fifteen patients (children and adolescents aged 6-19 years). Results: Protease inhibitors users had a higher prevalence of stunting (P = 0·03), lower BMI (P = 0·03) and lower percentage of body fat (P = 0·05) compared with non-users. There was no statistically significant difference between the HAART regimens and measurements of fat adiposity. Conclusions: The findings of the study suggest that children and adolescents under protease inhibitors are at higher risk of growth and development deviations, but not at risk of body fat redistribution.
“…The differences seen for stunting prevalence and body fat percentage according to HAART regimens might be correlated and derived from growth deviations. However, it is important to point out that some authors have not considered bioelectrical impedance analysis a good parameter for assessing body fat abnormalities in the paediatric population (7,9) . Contri et al (7) evaluated patients aged 3-17 years under HAART and found that both groups (receiving and not receiving PI therapy) had similar and unchanged body composition.…”
Section: ‡Whomentioning
confidence: 99%
“…Despite the fact that bioelectrical impedance analysis has been used to assess body composition in HIVinfected children, it is difficult to analyse the results due to the lack of standards for children. Besides that, bioelectrical impedance analysis measures only whole-body fat and lean body mass, which does not allow the identification of body fat distribution abnormalities (9) . It is important to emphasize that alterations associated with antiretroviral therapy are likely a result of complex interactions between HIV infection, specific antiretroviral agents, age, gender, as well as host genetic and lifestyle factors (30) .…”
Section: ‡Whomentioning
confidence: 99%
“…Although beneficial to the prognosis of HIV infection, exposure to HAART has been associated with disturbances in the nutritional status of this population group (5)(6)(7)(8)(9) , including body fat distribution abnormalities, which may represent an increased risk for premature CVD (5,8) . HAART also does not seem to fully reverse the effects of HIV/AIDS on children's growth (10) .…”
Objective: Although the benefits of highly active antiretroviral therapy (HAART) have been documented, it is thought to be associated to disturbances in nutritional status. These disturbances may occur early in life and are poorly understood. The present study aimed to investigate the relationship between anthropometric parameters and body composition of perinatally HIV-infected children and adolescents under HAART, according to use and non-use of protease inhibitors. Design: Cross-sectional study undertaken between August and December 2007. Demographic, socio-economic, clinical and anthropometric data were collected from the patients. The χ 2 test, Wilcoxon rank sum test (Mann-Whitney) and t test were used to compare the following variables between users and non-users of protease inhibitors: age, gender, per capita income, HAART exposure, antiretroviral therapy adopted in the last three years, CD4 count, viral load, pubertal stage, nutritional status (BMI-for-age, height-for-age, waist and neck circumferences, triceps skinfold thickness, body fat percentage, upper-arm fat area and upper-arm muscle area). Setting: An HIV/AIDS out-patient clinic, São Paulo, Brazil. Subjects: One hundred and fifteen patients (children and adolescents aged 6-19 years). Results: Protease inhibitors users had a higher prevalence of stunting (P = 0·03), lower BMI (P = 0·03) and lower percentage of body fat (P = 0·05) compared with non-users. There was no statistically significant difference between the HAART regimens and measurements of fat adiposity. Conclusions: The findings of the study suggest that children and adolescents under protease inhibitors are at higher risk of growth and development deviations, but not at risk of body fat redistribution.
“…1 Nutritional deficiencies are common among people with HIV, including HIV-infected youth. [2][3][4][5][6][7][8] In HIV-infected adults, nutritional deficiencies have been shown to affect immune status, disease progression, and mortality. [7][8][9][10][11][12][13][14][15] With the advent of highly-active antiretroviral therapy (HAART), concerns over nutritional deficiencies in the HIVinfected population have shifted from AIDS wasting syndrome, growth stunting, and chronic diarrhea to newly described long-term complications associated with chronic HIV infection secondary to increased inflammation, oxidative stress, and immune activation.…”
Section: Introductionmentioning
confidence: 99%
“…30,35,36 To date, however, few studies have investigated nutritional intake in relation to population recommendations among HIV-infected youth in developed countries, despite the serious implications for HIV disease progression and complication development in this population. 2,6,17,29,[36][37][38] And, notably, the few studies that have investigated this important topic used less stringent methods than what is recommended for nutrient intake assessment and/or only explored a few specific micronutrients.…”
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