European Journal of Pediatrics

, Volume 172, Issue 8, pp 1089–1096 | Cite as

Long-term body composition and metabolic changes in HIV-infected children switched from stavudine to tenofovir and from protease inhibitors to efavirenz

  • Valentina Fabiano
  • Vania Giacomet
  • Alessandra Viganò
  • Giorgio Bedogni
  • Sara Stucchi
  • Lucia Cococcioni
  • Stefano Mora
  • Gian Vincenzo Zuccotti
Original Article
First Online:
Received:
Revised:
Accepted:

Abstract

This is an 8-year cohort study of 24 HIV-infected patients aged 5–17 years to assess body composition and metabolic changes after switching from lamivudine + stavudine (d4T) + protease inhibitors (PI) to lamivudine + tenofovir (TDF) + efavirenz (EFV). Body composition (dual-energy X-ray absorptiometry) and cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, glucose and insulin were measured annually. Linear mixed models and generalized linear mixed models were used to evaluate time changes of the outcome of interest. Body mass index increased linearly by 0.3 kg/m2/year (p < 0.001); waist circumference increased non-linearly from 68 to 74 cm (p = 0.004 for the linear term and p = 0.04 for the quadratic term). Percent body fat, percent trunk fat and percent bone mineral content increased linearly by 0.6 %/year (p = 0.005), 1.2 %/year (p < 0.001) and 0.02 %/year (p = 0.04), respectively. Percent arm fat remained stable (p = 0.5), and percent leg fat decreased linearly by 1.2 %/year (p < 0.001). The probability of low HDL was 0.2 % at baseline and remained stable during the study. The probability of high triglycerides was 3 % at baseline and increased linearly to become 11 % at the 8th year of follow-up (p = ns). The probability of high glucose was 1 % for the whole study duration. Conclusions: patients, after switching from d4T to TDF and from PI to EFV, show most of the changes in anthropometry and body composition associated with normal growth and no frankly pathological change in metabolic parameters.

Keywords

Children HIV infection Body composition Metabolic parameters 
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Notes

Acknowledgments

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Valentina Fabiano
    • 1
    • 4
  • Vania Giacomet
    • 1
  • Alessandra Viganò
    • 1
  • Giorgio Bedogni
    • 2
  • Sara Stucchi
    • 1
  • Lucia Cococcioni
    • 3
  • Stefano Mora
    • 3
  • Gian Vincenzo Zuccotti
    • 1
  1. 1.Department of PediatricsUniversity of Milan, L. Sacco HospitalMilanItaly
  2. 2.Clinical Epidemiology Unit, Liver Research CenterTriesteItaly
  3. 3.Laboratory of Pediatric Endocrinology, Division of Metabolic and Cardiovascular SciencesSan Raffaele Scientific InstituteMilanItaly
  4. 4.Clinica PediatricaA.O. Luigi Sacco—Polo UniversitarioMilanItaly

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