Long-term body composition and metabolic changes in HIV-infected children switched from stavudine to tenofovir and from protease inhibitors to efavirenz

Valentina Fabiano, Vania Giacomet, Alessandra Viganò, Giorgio Bedogni, Sara Stucchi, Lucia Cococcioni, Stefano Mora, Gian Vincenzo Zuccotti

Research output: Contribution to journalArticle

Abstract

This is an 8-year cohort study of 24 HIV-infected patients aged 5-17 years to assess body composition and metabolic changes after switching from lamivudine + stavudine (d4T) + protease inhibitors (PI) to lamivudine + tenofovir (TDF) + efavirenz (EFV). Body composition (dual-energy X-ray absorptiometry) and cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, glucose and insulin were measured annually. Linear mixed models and generalized linear mixed models were used to evaluate time changes of the outcome of interest. Body mass index increased linearly by 0.3 kg/m2/year (p <0.001); waist circumference increased non-linearly from 68 to 74 cm (p = 0.004 for the linear term and p = 0.04 for the quadratic term). Percent body fat, percent trunk fat and percent bone mineral content increased linearly by 0.6 %/year (p = 0.005), 1.2 %/year (p <0.001) and 0.02 %/year (p = 0.04), respectively. Percent arm fat remained stable (p = 0.5), and percent leg fat decreased linearly by 1.2 %/year (p <0.001). The probability of low HDL was 0.2 % at baseline and remained stable during the study. The probability of high triglycerides was 3 % at baseline and increased linearly to become 11 % at the 8th year of follow-up (p = ns). The probability of high glucose was 1 % for the whole study duration. Conclusions: patients, after switching from d4T to TDF and from PI to EFV, show most of the changes in anthropometry and body composition associated with normal growth and no frankly pathological change in metabolic parameters.

Original languageEnglish
Pages (from-to)1089-1096
Number of pages8
JournalEuropean Journal of Pediatrics
Volume172
Issue number8
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Body composition
  • Children
  • HIV infection
  • Metabolic parameters

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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