Metabolic disorders in vertically HIV-infected children: future adults at risk for cardiovascular disease
| Autor: | Claudia Fortuny, Pere Soler-Palacín, Francisco Javier Aracil, Rebeca Lahoz, Marta Dapena, María Isabel de José, Beatriz Jiménez, Concepción Figueras, Antoni Noguera-Julian |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Population HIV Infections Endocrinology Insulin resistance Metabolic Diseases Risk Factors Interquartile range Internal medicine medicine Humans Child education Lipoatrophy Dyslipidemias education.field_of_study business.industry Stavudine Hypertriglyceridemia Lipohypertrophy medicine.disease Infectious Disease Transmission Vertical Cross-Sectional Studies Cardiovascular Diseases Multivariate Analysis Pediatrics Perinatology and Child Health Female Insulin Resistance business Dyslipidemia medicine.drug |
| Zdroj: | ResearcherID Europe PubMed Central |
| ISSN: | 2191-0251 0334-018X |
| DOI: | 10.1515/jpem-2012-0005 |
| Popis: | Background: Despite metabolic disorders in HIV-infected children being widely described, there is still a lack of agreed criteria for diagnoses and management. Numerous studies are coming from other settings and results are heterogeneous when assessing several analytical and clinical parameters. Objectives: To describe the prevalence of metabolic disorders and associated risk factors in the Spanish National cohort of HIV-infected pediatric patients (CoRISpe). Methods: This was a cross-sectional study following all vertically HIV-infected children and adolescents in three referral centers included in the CoRISpe. Metabolic data (fasting lipids, glucose and insulin levels and thyroid hormone levels) were collected. Fat distribution was clinically assessed by expert clinicians. Results: We included 157 patients [median age 13 years, interquartile range (IQR) 10 – 16]. Median duration of antiretroviral therapy was 10.2 years (IQR 5.0 – 13.0). Almost 20 % of patients had insulin resistance and this was associated with hepatitis C co-infection, current use of stavudine (d4T) and hypertriglyceridemia. Hypercholesterolemia and hypertriglyceridemia were found in 23.9 % and 24.8 % of patients and were associated with current use of protease inhibitors (p = 0.042 and p = 0.022, respectively). Abnormal fat distribution was observed in 63 patients (40.5 % ): lipoatrophy in 32 (20.4 % ), lipohypertrophy in eight (5.1 % ) and a mixed pattern in 23 patients (14.6 % ), and it was signifi cantly associated with previous exposure to stavudine (p < 0.001). Conclusions: Metabolic disorders are a signifi cant problem in our HIV-infected pediatric population. We need to encourage the development of global strategies and the creation of consensus guidelines that can decrease the cardiovascular risk in this population. |
| Databáze: | OpenAIRE |
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