ABSTRACT
Alterations in regional fat, often associated with abnormalities in lipid and insulin metabolism, have been reported in HIV-infected adults. To determine whether similar abnormalities occur in children with HIV, patterns of change in regional body fat distribution were determined by dual energy x-ray absorptiometry in 28 prepubertal HIV-infected children. Eight (29%) children experienced lipodystrophy (LD), defined as extremity lipoatrophy together with trunk fat accumulation. Despite a mean body weight increase of 2.9 +/- 2.4 kg, children with LD experienced a mean loss of total fat in contrast to children without LD who increased total fat (-0.151 +/- 0.324 versus 0.981 +/- 1.041 kg; p <.01). Children with LD had significantly higher levels of HIV RNA and lower CD4 count and percentage at baseline. LD was associated with use of protease inhibitors or stavudine, (odds ratio [OR], 7.0, 95% confidence interval [CI], 1.1-45.2, p =.04; OR, 9.0, 95% CI, 1.4-59.8, p =.03, respectively). This observational study suggests that during a time in childhood when accumulation of extremity and trunk fat is expected, some HIV-infected children experience changes in fat distribution that are similar to HIV-associated LD reported in adults. Studies to determine whether HIV-infected children with changes in regional fat also experience increases in "atherogenic" lipids and insulin resistance as described in adults with HIV-associated LD are warranted.
Subject(s)
Anti-HIV Agents/adverse effects , Body Composition , HIV Infections/complications , HIV-1/physiology , Lipodystrophy/etiology , Absorptiometry, Photon/methods , Anti-HIV Agents/therapeutic use , CD4 Lymphocyte Count , Child , Drug Therapy, Combination , Female , HIV Infections/drug therapy , HIV Infections/immunology , HIV Infections/virology , HIV Protease Inhibitors/adverse effects , HIV Protease Inhibitors/therapeutic use , Humans , Lipodystrophy/immunology , Lipodystrophy/virology , Male , Reverse Transcriptase Inhibitors/adverse effects , Reverse Transcriptase Inhibitors/therapeutic use , Risk Factors , Stavudine/adverse effects , Stavudine/therapeutic use , Viral LoadABSTRACT
The study objectives were to assess the relationships among human immunodeficiency virus (HIV) replication, energy balance, body composition and growth in children with HIV-associated growth failure (GF). Energy intake and expenditure, body composition and level of HIV RNA were measured in 16 HIV-infected children with growth failure (HIV+/GF+), defined as a 12-mo height velocity
Subject(s)
Body Composition , Energy Intake , Growth , HIV Infections/physiopathology , HIV Infections/virology , Viral Load , Body Height , Body Weight , CD4 Lymphocyte Count , Child , Energy Metabolism , Female , HIV/genetics , HIV/physiology , Humans , Male , RNA, Viral/analysis , Regression AnalysisSubject(s)
Adrenocortical Hyperfunction/chemically induced , Anti-HIV Agents/adverse effects , HIV Infections/drug therapy , Hypertriglyceridemia/chemically induced , Obesity/chemically induced , Abdomen/pathology , Anti-HIV Agents/administration & dosage , Child , Drug Therapy, Combination , Humans , Infectious Disease Transmission, Vertical , Magnetic Resonance Imaging , MaleABSTRACT
The purpose of this study was to evaluate the performance of bioimpedance analysis (BIA) in the prediction of total body water and fat free mass with the use of standard equations in assessing 20 prepubertal children infected with human immunodeficiency virus (HIV). Total body water was measured by means of deuterium oxide dilution, fat free mass by means of total body dual X-ray absorptiometry, and BIA with a bioelectrical impedance analyzer. The use of standard prediction equations resulted in substantial error. Regression equations using height and BIA resistance for estimating total body water and fat free mass were developed and appear to improve accuracy for prediction. This study suggests that total body water and fat free mass can be estimated in children with HIV by means of BIA equations specifically developed for use with this group of children.
