在停用司他夫定后，围产期感染艾滋病毒的儿童和青少年出现脂肪代谢障碍及面部脂肪萎缩的逆转情况。

Lipodystrophy and reversal of facial lipoatrophy in perinatally HIV-infected children and adolescents after discontinuation of stavudine.

作者信息

Sawawiboon N, Wittawatmongkol O, Phongsamart W, Prasitsuebsai W, Lapphra K, Chokephaibulkit K

机构信息

Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok-noi Bangkok 10700 Thailand.

出版信息

Int J STD AIDS. 2012 Jul;23(7):497-501. doi: 10.1258/ijsa.2011.011348.

DOI:10.1258/ijsa.2011.011348

PMID:22844004

Abstract

Lipodystrophy (LD) was evaluated in 205 children receiving antiretroviral therapy by a single investigator: 51 (24.9%) had LD; 46 peripheral lipoatrophy, three central lipohypertrophy and two combined type. All cases of peripheral and combined LD also had facial lipoatrophy. Serial photographs were provided by the families to confirm the severity of facial lipoatrophy. Forty-six (95.8%) children with peripheral or combined LD, and 75 (48.7%) without LD were exposed to stavudine (d4T) for a median duration of 45.9 versus 26.4 months (P = 0.005). In multivariate analysis, exposure to d4T for more than three months was the only factor associated with peripheral or combined LD (P < 0.001). Noticeable improvement of facial lipoatrophy was found in 11/48 (22.9%) children after a mean duration of 45.6 months following d4T discontinuation, mostly occurring during early adolescence.

摘要

一名研究人员对205名接受抗逆转录病毒治疗的儿童进行了脂肪代谢障碍（LD）评估：51名（24.9%）患有LD；46名有外周性脂肪萎缩，3名有中央性脂肪肥大，2名有混合型。所有外周性和混合型LD病例也都有面部脂肪萎缩。家属提供了系列照片以确认面部脂肪萎缩的严重程度。46名（95.8%）患有外周性或混合型LD的儿童以及75名（48.7%）未患LD的儿童曾接受司他夫定（d4T）治疗，中位治疗时长分别为45.9个月和26.4个月（P = 0.005）。在多变量分析中，接受d4T治疗超过三个月是与外周性或混合型LD相关的唯一因素（P < 0.001）。在停用d4T后的平均45.6个月期间，11/48（22.9%）的儿童面部脂肪萎缩有明显改善，大多发生在青春期早期。