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. 2017 Jan 1;74(1):e1-e8.
doi: 10.1097/QAI.0000000000001163.

Association of Dyslipidemia and Glucose Abnormalities With Antiretroviral Treatment in a Cohort of HIV-Infected Latin American Children

Machline P Paganella  1 , Rachel A Cohen, Donald R Harris, Ricardo de Souza Kuchenbecker, Rosa D Sperhacke, Sergio K Kato, Carmem L Oliveira da Silva, Fernanda T Sturzbecher, Ricardo H S Oliveira, Noris Pavía-Ruz, Rohan Hazra; NISDI PLACES Protocol
Affiliations

Association of Dyslipidemia and Glucose Abnormalities With Antiretroviral Treatment in a Cohort of HIV-Infected Latin American Children

Machline P Paganella et al. J Acquir Immune Defic Syndr. .

Abstract

Objective: To estimate the incidence of lipid and glucose abnormalities and assess their association with exposure to antiretroviral (ARV) regimens among perinatally HIV-infected Latin American children.

Design: Longitudinal cohort study.

Methods: Data were analyzed from the Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative Pediatric Latin American Countries Epidemiologic Study. The incidence of dyslipidemia [total cholesterol >200 mg/dL, HDL < 35 mg/dL, LDL ≥ 130 mg/dL, triglycerides > 110 mg/dL (age < 10 years) or >150 mg/dL (≥10 years)] and fasting glucose abnormalities [homeostasis model assessment of insulin resistance >2.5 (Tanner stage 1) or >4.0 (Tanner stage > 1); impaired glucose: 110 to <126 mg/dL; diabetes: ≥126 mg/dL] was estimated. Proportional hazards regression was used to evaluate the risk of abnormalities associated with ARV regimen, adjusted for covariates.

Results: There were 385 children eligible for analysis (mean age 6.6 years). Incident cholesterol abnormalities were reported in 18.1% of participants [95% confidence interval (CI): 14.1% to 22.8%], HDL and LDL cholesterol abnormalities in 19.6% (15.1%-24.7%) and 15.0% (11.3%-19.5%), respectively, and triglyceride abnormalities in 44.2% (37.7%-50.8%). In multivariable analysis, ARV regimen was only associated with triglyceride abnormalities; participants receiving a protease inhibitor (PI)-containing regimen were 3.6 times as likely to experience a triglyceride abnormality as those receiving no ARVs (95% CI: 1.3 to 10.5; P = 0.0167). The cumulative incidence of insulin resistance was 3.8% (1.8%-7.1%); there were no incident cases of diabetes and only 2 of impaired fasting glucose.

Conclusions: Children receiving PI-containing regimens were at increased risk of developing triglyceride abnormalities. Continued monitoring of lipid levels in children receiving PI-containing regimens appears warranted.

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Conflict of interest statement

The authors have no other funding or conflicts of interest to declare.

Figures

Figure 1
Figure 1. Study Population Derivation
** Any child with a diagnosis of type I diabetes, nephrotic or nephritic syndrome, uremia, or hypothyroidism was excluded.
See this image and copyright information in PMC

References

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