Ene Luminita, Goetghebuer Tessa, Hainaut Marc, Peltier Alexandra, Toppet Véronique, Levy Jack
Department of Pediatric AIDS, Dr. Victor Babes Hospital for Infectious Disease, 281 Sos Mihai Bravu, Sector 3, Bucharest, Romania.
Eur J Pediatr. 2007 Jan;166(1):13-21. doi: 10.1007/s00431-006-0193-1. Epub 2006 Jul 29.
The aim of this study was to assess the changes in body fat distribution and lipid abnormalities in a population of HIV-infected children and adolescents followed in one single centre who had been exposed, or not, to antiretroviral therapy (ART).
Patients aged between 3 and 19 years were evaluated in a cross-sectional study carried out between October and December 2002. Fat redistribution was evaluated independently by the physician and the patient. Fasting blood lipid profile, glucose, insulin and C peptide were measured. Among the 88 patients evaluated, 74 were taking ART.
Fat redistribution was present in 20 patients, metabolic alterations alone were found in 22 children and 46 children had neither physical nor metabolic abnormalities. Patients with fat redistribution were found to have been on ART for a significantly longer period of time, with 42% of the children showing fat redistribution having been treated with antiretroviral agents for more than 5 years. These children had also been exposed to a higher number of antiretroviral agents. In contrast, metabolic alterations in the absence of fat redistribution were not related to the duration of ART nor to the number of drugs received. Treatment with stavudine or protease inhibitors was significantly associated with the presence of physical changes.
Regular assessment of fat redistribution and metabolic markers should be carried out in children treated with antiretroviral agents and taken into account when adapting therapy during the long-term follow up of these children.
本研究旨在评估在单一中心接受随访的感染人类免疫缺陷病毒（HIV）的儿童和青少年群体中，接受或未接受抗逆转录病毒治疗（ART）者的体脂分布变化和脂质异常情况。
在2002年10月至12月进行的一项横断面研究中，对年龄在3至19岁之间的患者进行了评估。由医生和患者分别独立评估脂肪重新分布情况。测量空腹血脂谱、血糖、胰岛素和C肽。在评估的88例患者中，74例正在接受ART治疗。
20例患者存在脂肪重新分布，22例儿童仅发现代谢改变，46例儿童既无身体异常也无代谢异常。发现有脂肪重新分布的患者接受ART治疗的时间明显更长，42%出现脂肪重新分布的儿童接受抗逆转录病毒药物治疗超过5年。这些儿童还接触过更多种类的抗逆转录病毒药物。相比之下，无脂肪重新分布的代谢改变与ART治疗时间或所接受药物的数量无关。使用司他夫定或蛋白酶抑制剂治疗与身体变化显著相关。
对于接受抗逆转录病毒药物治疗的儿童，应定期评估脂肪重新分布和代谢指标，并在对这些儿童进行长期随访调整治疗方案时予以考虑。
