Body fat changes in children

Body fat changes have also been reported in children and adolescents receiving HAART. As in studies of adults, many of the studies have been cross-sectional and/or retrospective. Detecting body fat changes in growing children is also more complicated than it is in adults. While an early retrospective review of over 1600 HIV-positive children on protease inhibitors found that only 1% had visible changes in their body shape and composition, 1 most studies have reported higher rates of body fat changes among children on HAART - although generally lower than the rates seen in adults : 20%, 2 3 24%, 4 26%, 5 28%, 6 7 33%.

In at least one study, the combined syndrome of fat wasting and central fat accumulation tended to be more frequent and severe in adolescents, consistent with the observation that inherited forms of lipodystrophy tend to develop or worsen after the onset of puberty. Twenty-three per cent of children without body fat changes in the cohort had lipid abnormalities, although changes in glucose tolerance were less pronounced in pre-pubescent children.

A European study of 477 HIV-positive children and adolescents, found that an AIDS diagnosis, female sex, and the use of a protease inhibitor or d4T were risk factors for lipodystrophy. Of the 26% of the children and adolescents who showed signs of body fat redistribution, 29% had fat loss, 34% had fat accumulation, and 37% had a combination of both. 5 Other studies have found that girls are more prone to lipodystrophy than boys, although less likely to experience fat loss, 6 and that metabolic changes are frequent even in children without visible lipodystrophy.2 7 3

References

  1. Babi FE et al. Abnormal body-fat distribution in HIV-infected children on antiretrovirals. Lancet 353: 1243-1244, 1999
  2. Amaya RA et al. Lipodystrophy syndrome in human immunodeficiency virus-infected children. Pediatr Infect Dis J 21: 405-410, 2002
  3. Tellol LM et al. Alterations in lipid metabolism and lipodystrophy related to HIV in infected children. Fourteenth International AIDS Conference, Barcelona, abstract TuPeB4531, 2002
  4. Beregszaszi M et al. Longitudinal evaluation and risk factors of lipodystrophy and associated metabolic changes in HIV-infected children. J Acquir Immune Defic Syndr 40: 161-168, 2005
  5. European Paediatric Lipodystrophy Group Antiretroviral therapy, fat redistribution and hyperlipidaemia in HIV-infected children in Europe. AIDS 18: 1443-1451, 2004
  6. Vigano A et al. Increased lipodystrophy is associated with increased exposure to highly active antiretroviral therapy in HIV-infected children. J Acquir Immune Defic Syndr 32(5):482-489, 2003
  7. Meneilly G et al. Metabolic and body composition changes in HIV-infected children on antiretroviral therapy. Eighth Conference on Retroviruses and Opportunistic Infections, Chicago, abstract 650, 2001
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

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We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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