The Indian Journal of Pediatrics

, 76:1017

Lipodystrophy and metabolic complications of highly active antiretroviral therapy

  • Ankit Parakh
  • Anand Prakash Dubey
  • Ajay Kumar
  • Anshu Maheshwari
Original Article

DOI: 10.1007/s12098-009-0216-9

Cite this article as:
Parakh, A., Dubey, A.P., Kumar, A. et al. Indian J Pediatr (2009) 76: 1017. doi:10.1007/s12098-009-0216-9

Abstract

Objective

To assess the metabolic drug toxicities of first-line, World Health Organization (WHO)-recommended generic highly active antiretroviral therapy (HAART) regimens, to estimate the prevalence of body fat redistribution and to identify associated risk factors.

Methods

Cross-sectional observational study. During 3 month period, 52 HIV infected children (25 on HAART; 27 not on HAART) were assessed. Their sociodemographic, clinical, and immunological data was recorded. Children were examined or the signs of fat redistribution (peripheral lipoatrophy and central lipohypertrophy). Liver function tests, fasting blood sugar, lipid profile, serum amylase, serum lactate, blood pH and bicarbonate levels were done in all patients.

Results

Twenty-two patients were on stavudine and three on zidovudine based HAART. None of the patients ever received any protease inhibitor. There were no cases of clinical or immunological failure. Children on HAART had significantly lower weight for age and body mass index but the mean height for age was similar between study groups. Only two cases of peripheral lipoatrophy were observed. Hypercholesterolemia was observed in four children on HAART but none without therapy. Hypertriglyceridemia was observed in three children on HAART and seven without therapy. Four cases of asymptomatic mild hyperlactatemia were observed. No case of any hyperglycemia or liver impairment was observed.

Conclusion

Metabolic abnormalities and lipodystrophy are emerging complications of HAART in Indian children and needs very close follow up. Future studies with larger sample size and longitudinal model are recommended.

Key words

ChildrenDyslipidemiaHAARTIndiaLipodystrophy

Copyright information

© Dr. K C Chaudhuri Foundation 2009

Authors and Affiliations

  • Ankit Parakh
    • 1
    • 2
  • Anand Prakash Dubey
    • 1
  • Ajay Kumar
    • 1
  • Anshu Maheshwari
    • 1
  1. 1.Department of PediatricsMaulana Azad Medical College and Associated HospitalsNew DelhiIndia
  2. 2.DelhiIndia