Growth Aspects of HIV-Infected Adolescents in South America

  • Cristina B. Hofer


HIV infection epidemiology in adolescents is divided into two groups: vertical and sexual transmission. When both groups have access to antiretroviral therapy, and HIV becomes a chronic disease, several nutritional issues are observed and must be better studied in South American population. In HIV vertically infected adolescents, who were exposed to several antiretroviral practices, including antiretroviral regimens of lower potency used in the past, the main problem is related to lower stature when compared to the same-age population, but not necessarily lower weight. As a consequence, a cohort with higher body mass index has been created. Adolescents with HIV who had been sexually infected are probably those who are recently infected, and they reflect the epidemiology of HIV in South America: more prevalent among young and poor females. The study of the nutritional aspects of this population demonstrates a fiber poor, fat rich diet in a population without the right nutritional knowledge with higher tendency to be overweight. In the population that is using antiretrovirals, the frequency of lipodystrophy syndrome, i.e., fat redistribution (mainly lipohypertrophy) and metabolic alterations, such as dyslipidemia, insulin resistance, or lactic acidosis, is higher than in the population without medication, and factors associated with this syndrome and several consequences are discussed in this chapter.


Human Immunodeficiency Virus Lactic Acidosis Nutritional Knowledge Brazilian Child Lipodystrophy Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.





Body mass index


Highly active antiretroviral therapy


Human immunodeficiency virus


Socioeconomic status


  1. Alves C, Oliveira AC, Brites C. Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus. Braz J Infect Dis. 2008;12:342–8.PubMedCrossRefGoogle Scholar
  2. Antunes MC, Peres CA, Paiva V, Stall R, Hearst N. Differences in AIDS prevention among young men and women of public schools in Brazil. Rev Saude Publica. 2002;36:88–95.PubMedCrossRefGoogle Scholar
  3. Barbiero SM, Pellanda LC, Cesa CC, Campagnolo P, Beltrami F, Abrantes CC. Overweight, obesity and other risk factors for IHD in Brazilian schoolchildren. Public Health Nutr. 2009;12:710–5.PubMedCrossRefGoogle Scholar
  4. Buonora S, Nogueira S, Pone MV, Aloé M, Oliveira RH, Hofer C. Growth parameters in HIV-vertically-infected adolescents on antiretroviral therapy in Rio de Janeiro, Brazil. Ann Trop Paediatr. 2008;Mar 28:59–64.PubMedCrossRefGoogle Scholar
  5. Centers for Disease Control and Prevention. MMWR. 1994 Revised classification system for human immunodeficiency virus infection in children less than 13 years of age. 1994;43:1–10.Google Scholar
  6. European Paediatric Lipodystrophy Group. Antiretroviral therapy, fat redistribution and hyperlipidaemia in HIV-infected children in Europe. AIDS. 2004;18:1443–51.CrossRefGoogle Scholar
  7. Filho LF, Nogueira SA, Machado ES, Abreu TF, de Oliveira RH, Evangelista L, Hofer CB. Factors associated with lack of antiretroviral adherence among adolescents in a reference centre in Rio de Janeiro, Brazil. Int J STD AIDS. 2008;19:685–8.PubMedCrossRefGoogle Scholar
  8. Foster C, Lyall EG. Children with HIV: improved mortality and morbidity with combination antiretroviral therapy. Curr Opin Infect Dis. 2005;18:253–9.PubMedCrossRefGoogle Scholar
  9. Hofer CB, Machado ES, Costa TP, Nogueira SA. Pregnancy in HIV infected adolescents in Rio de Janeiro, Brazil. 3rd International AIDS Society, Rio de Janeiro, Brazil; 2005.Google Scholar
  10. Joy T, Keogh HM, Hadigan C, Lee H, Dolan SE, Fitch K, Liebau J, Lo J, Johnsen S, Hubbard J, Anderson EJ, Grinspoon S. Dietary fat intake and relationship to serum lipid levels in HIV-infected patients with metabolic abnormalities in the HAART era. AIDS. 2007;21:1591–1600.PubMedCrossRefGoogle Scholar
  11. Melchior R, Nemes MI, Basso CR, Castanheira ER, Alves MT, Buchalla CM, Donini AA. Evaluation of the organizational structure of HIV/AIDS outpatient care in Brazil. Rev Saude Publica. 2006;40:143–51.PubMedCrossRefGoogle Scholar
  12. Morales AU, Barreda PZ. HIV vulnerability in women at social risk. Rev Saude Publica. 2008;42:822–9.PubMedCrossRefGoogle Scholar
  13. Sánchez-Torres AM, Munoz Muniz R, Madero R, Borque C, García-Miguel MJ, De José Gómez MI. Prevalence of fat redistribution and metabolic disorders in human immunodeficiency virus-infected children. Eur J Pediatr. 2005;164:271–6.PubMedCrossRefGoogle Scholar
  14. Sarni RO, de Souza FI, Battistini TR, Pitta TS, Fernandes AP, Tardini PC, Fonseca FL, Dos Santos VP, Lopez FA. Lipodystrophy, lipid profile changes, and low serum retinol and carotenoid levels in children and adolescents with acquired immunodeficiency syndrome. J Pediatr. 2009;85:329–34.CrossRefGoogle Scholar
  15. Scott GB, Hutto C, Makuch RW, Mastrucci MT, O’Connor T, Mitchell CD, Trapido EJ, Parks WP. Survival in children with perinatally acquired human immunodeficiency virus type 1 infection. N Engl J Med. 1989;321:1791–6.Google Scholar
  16. Toral N, Slater B. Perception of eating practices and stages of change among Brazilian adolescents. Prev Med. 2009;48:279–83.PubMedCrossRefGoogle Scholar
  17. UNAIDS Report. 2008. In: Access on March, 8th 2009.
  18. da Veiga GV, da Cunha AS, Sichieri R. Trends in overweight among adolescents living in the poorest and richest regions of Brazil. Am J Public Health. 2004;94:1544–8.PubMedCrossRefGoogle Scholar
  19. Werner MLF. Alterações metabólicas e de distribuição de gordura corporal em crianças e adolescentes infectados pelo HIV/AIDS em uso de drogas antiretrovirais de alta potência. Instituto Fernandes Figueira, Rio de Janeiro; 2005.Google Scholar

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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Infectious Diseases Service, Preventive Medicine DepartmentInstituto de Puericultura e Pediatria Martagao Gesteira, Universidade Federal do Rio de JaneiroRio de JaneiroBrazil

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