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印度北部接受高效抗逆转录病毒治疗的HIV感染儿童中的脂肪代谢障碍综合征

Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India.

作者信息

Bhutia Euden, Hemal Alok, Yadav Tribhuvan Pal, Ramesh K L

机构信息

Department of Neonatology and Pediatric Medicine, PGIMER, Dr. RML Hospital, New Delhi, India.

Department of Biochemistry, PGIMER and Dr. RML Hospital, New Delhi, India.

出版信息

Afr Health Sci. 2014 Jun;14(2):408-13. doi: 10.4314/ahs.v14i2.17.

Abstract

BACKGROUND

It is estimated that about 2.5 million people are living with HIV infection in India. Although antiretroviral drugs have been able to reduce the mortality, these drugs have serious side effects one of which is lipodystrophy syndrome. Most of the drugs used in HAART viz, protease inhibitors, stavudine and nevirapine are associated with lipodystrophy. Hence we conducted this study to assess the prevalence of lipodystrophy in HIV infected children on HAART and its associated risk factors.

MATERIALS AND METHODS

A cross sectional study was conducted on 80 HIV infected children aged 2-18 years of age who were on stavudine based HAART for ≥ 2 years. These children were assessed for presence of lipodystrophy, its metabolic complications and associated risk factors.

RESULTS

Lipodystrophy was observed in 33.7% of children with lipoatrophy being the commonest subtype followed by lipohypertrophy. Older age, increased duration of treatment and dyslipidaemia were found to be associated in patients with lipodystrophy than those without. On further multivariate analysis of independent risk factors only increased duration of treatment was significantly associated with lipodystrophy. No association was found with insulin resistance.

CONCLUSION

We observed that lipodystrophy is a common finding in HIV patients treated with HAART for long duration.

摘要

背景

据估计,印度约有250万人感染了艾滋病毒。尽管抗逆转录病毒药物能够降低死亡率,但这些药物有严重的副作用,其中之一是脂肪代谢障碍综合征。高效抗逆转录病毒治疗(HAART)中使用的大多数药物,即蛋白酶抑制剂、司他夫定和奈韦拉平,都与脂肪代谢障碍有关。因此,我们开展了这项研究,以评估接受HAART治疗的艾滋病毒感染儿童中脂肪代谢障碍的患病率及其相关危险因素。

材料与方法

对80名年龄在2至18岁、接受基于司他夫定的HAART治疗≥2年的艾滋病毒感染儿童进行了一项横断面研究。对这些儿童进行了脂肪代谢障碍的存在情况、其代谢并发症及相关危险因素的评估。

结果

33.7%的儿童出现了脂肪代谢障碍,其中脂肪萎缩是最常见的亚型,其次是脂肪增生。与未患脂肪代谢障碍的患者相比,年龄较大、治疗时间延长和血脂异常在患脂肪代谢障碍的患者中更为常见。在对独立危险因素进行进一步多变量分析时,只有治疗时间延长与脂肪代谢障碍显著相关。未发现与胰岛素抵抗有关。

结论

我们观察到,脂肪代谢障碍在长期接受HAART治疗的艾滋病毒患者中是一个常见现象。

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