人类免疫缺陷病毒感染儿童脂肪重新分布及代谢紊乱的预防

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In this study we assessed the prevalence of fat redistribution and metabolic d isorders in a population of HIV-infected children on antiretroviral treatment. To make associations with epidemiological parameters, clinical-immunestatus, vi ral load and highly active antiretroviral therapy (HAART), we performed a cross -sectional study in HIV-infected children. Epidemiological parameters (age, se x, family history), clinical and immune status, viral load, and duration of anti retroviral treatment (ART) and HAART, including protease inhibitors, were record ed. Presence of clinical signs of fat redistribution and lipid, glucose and lact ic acid levels were evaluated. A total of 56 HIV-infected children, including 3 0 boys (54%), aged between 21 months and 18 years (mean 9.5 years) were studied . In all, 49 patients (87.5%) were receiving ART (mean duration 4 years) and 43 (77%) were receiving HAART (mean duration 3.6 years). Fat redistribution or li podystrophy was present in 14 patients (25%); seven had lipohypertrophy (12.5% ), two lipoatrophy (3.5%) and five amixed pattern (8.9%). Fat redistribution w as higher in children older than 11 years (50%). Of the lipodystrophic patients , 71.4%presented hypertriglyceridaemia (>130 mg/dl) and 57%hypercholesterolaem ia (>180 mg/dl). We found significant associations between lipodystrophy and age , ART and HAART duration and hypertriglyceridaemia (P <0.001, 0.002, 0.016 and < 0.001, respectively), but no significant association with sex, family history, clinical or immune status and viral load. Conclusion: The prevalence of lipo-dy strophy was 25%(95%confidence interval 14.8-34.6) with lipohypertrophy being the commonest pattern. Clinical fat redistribution was significantly associated with older age, duration of antiretroviral treatment and highly active antiretro viral therapy and hypertriglyceridaemia. In this study we assessed the prevalence of fat redistribution and metabolic d isorders in a population of HIV-infected children on antiretroviral therapy. To make associations with epidemiological parameters, clinical-immunestatus, viral load and highly active antiretroviral therapy (HAART), we Epidemiological parameters (age, se x, family history), clinical and immune status, viral load, and duration of anti retroviral treatment (ART) and HAART, including protease inhibitors, were record ed. Presence of clinical signs of fat redistribution and lipid, glucose and lact ic acid levels were evaluated. A total of 56 HIV-infected children, including 30 boys (54%), aged between 21 months and 18 years (mean 9.5 years Fat redistribution or li podystrophy was present in 14 patients (87.5%) were receiving ART (mean duration 4 years) and 43 (77%) were receiving HAART (mean duration 3.6 years) Fat redistribution w as higher in children older than 11 years (50%). Of the lipodystrophic patients, 71.4% We found significant associations between lipodystrophy and age, ART and HAART duration and hypertriglyceridaemia (P <0.001, 0.002, 0.016 and <0.001, respectively) ): but no significant association with sex, family history, clinical or immune status and viral load. Conclusion: The prevalence of lipo-dy strophy was 25% (95% confidence interval 14.8-34.6) with lipohypertrophy being the commonest pattern. Clinical fat redistribution was significantly associated with older age, duration of antiretroviral treatment and highly active antiretro viral therapy and hypertriglyceridaemia.
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