Insulin Resistance and Markers of Inflammation in HIV-infected Ugandan Children in the CHAPAS-3 Trial.
| Autor: | Dirajlal-Fargo S; From the *Case Western Reserve University, and†Rainbow Babies and Children's Hospital, Cleveland, Ohio; ‡Joint Clinical Research Centre, and §Makerere University College of Health Sciences, Kampala, Uganda; ¶MRC Clinical Trials Unit University College, and ‖Institute of Child Health University College, London, United Kingdom., Musiime V, Cook A, Mirembe G, Kenny J, Jiang Y, Debanne S, Klein N, McComsey GA |
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| Jazyk: | angličtina |
| Zdroj: | The Pediatric infectious disease journal [Pediatr Infect Dis J] 2017 Aug; Vol. 36 (8), pp. 761-767. |
| DOI: | 10.1097/INF.0000000000001544 |
| Abstrakt: | Background: Few studies have investigated metabolic complications in HIV-infected African children and their relation with inflammation. Methods: We compared baseline and changes in insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR)] and in markers of inflammation over 48 weeks, in a subset of antiretroviral therapy (ART)-naive Ugandan children from the Children with HIV in Africa-Pharmacokinetics and Adherence/Acceptability of Simple Antiretroviral Regimens trial randomized to zidovudine-, stavudine- or abacavir (ABC)-based regimen. Nonparametric methods were used to explore between-group and within-group differences, and multivariable analysis to assess associations of HOMA-IR. Results: One-hundred eighteen children were enrolled, and median age (interquartile range) was 2.8 years (1.7-4.3). Baseline median HOMA-IR (interquartile range) was 0.49 (0.38-1.07) and similar between the arms. At week 48, median relative changes in HOMA-IR were 14% (-29% to 97%) in the zidovudine arm, -1% (-30% to 69%) in the stavudine arm and 6% (-34% to 124%) in the ABC arm (P ≤ 0.03 for all the arms compared with baseline, but P = 0.90 for between-group differences). Several inflammation markers significantly decreased in all study arms; soluble CD14 increased on ABC and did not change in the other 2 arms. In multivariate analysis, only changes in soluble CD163 were positively associated with HOMA-IR changes. Conclusions: In ART-naive Ugandan children, HOMA-IR changed significantly after 48 weeks of ART and correlated with monocyte activation. |
| Databáze: | MEDLINE |
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