Lipodistrofia em crianças e adolescentes com síndrome da imunodeficiência adquirida e sua relação com a terapia antirretroviral empregada

• Autor(a) principal: Sarni, Roseli Oselka Saccardo [UNIFESP]
• Data de Publicação: 2009
• Outros Autores: Souza, Fabíola Isabel Suano de [UNIFESP], Battistini, Tânia Regina Beraldo, Pitta, Tassiana Sacchi, Fernandes, Ana Paula, Tardini, Priscila Chemiotti, Fonseca, Fernando Luiz Affonso [UNIFESP], Santos, Valter Pinho dos [UNIFESP], Lopez, Fábio Ancona [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.2223/JPED.1910; http://repositorio.unifesp.br/handle/11600/5183
• topic: Acquired immunodeficiency syndrome; lipodystrophy; dyslipidemias; pediatrics; antiretroviral agents; Síndrome da imunodeficiência adquirida; lipodistrofia; dislipidemias; pediatria; agentes antirretrovirais

OBJECTIVE: To evaluate the presence of clinical lipodystrophy in children with the acquired immunodeficiency syndrome and to relate it to the antiretroviral regimen employed, to changes in lipid profile and to insulin resistance. METHODS: This was a cross-sectional study that evaluated 30 children and adolescents (median age = 9.1 years) with the acquired immunodeficiency syndrome during 2004 and 2005. The following clinical and laboratory evaluations were performed: classification of HIV infection, anthropometric measurements (weight and height), serum glycemia, serum insulin and lipid profile (LDL-c, HDL-c, triglycerides). Lipodystrophy was diagnosed using clinical parameters. The chi-square test was used for statistical analysis. RESULTS: All of the patients were taking antiretroviral therapy regularly (median duration of 28.4 months); 80% were on three drugs in combination (highly active therapy) and 30% were on protease inhibitors. Lipodystrophy and dyslipidemia were observed in 53.3 and 60% of the patients, respectively. Children on a highly active therapy regimen with protease inhibitors exhibited a higher percentage of mixed lipodystrophy; the difference between these children and the group on highly active therapy without protease inhibitors and the group not on a highly active therapy was statistically significant (44.4 vs. 16.7%; p = 0.004). There was no statistically significant association between the presence of lipodystrophy and sex, age (> 10 years), changes to the lipid profile or insulin resistance. CONCLUSIONS: The elevated prevalence of dyslipidemia and lipodystrophy observed among children with acquired immunodeficiency syndrome, which exhibited a relationship with the antiretroviral regimen employed, may represent an increased risk for future complications, in particular cardiovascular problems.