Dyslipidemia Management in Patients With Human Immunodeficiency Virus

Brett-Major, David M.; Ganesan, Anuradha

doi:10.1097/01.idc.0000239720.32336.99

Cited by 2 publications

(3 citation statements)

References 63 publications

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“…A própria infecção pelo HIV é associada a um perfil lipídico pró-aterogênico caracterizado pelo aumento de triglicérides e da concentração de partículas menos densas da fração LDL do colesterol e pela redução dos níveis de HDL-c 23,24 .…”

Section: Lipodistrofia Presente (N = 16) Lipodistrofia Ausente (N = 14)unclassified

Lipodystrophy in children and adolescents with acquired immunodeficiency syndrome and its relationship with the antiretroviral therapy employed

Sarni¹,

Souza²,

Battistini³

et al. 2009

J Pediatr (Rio J)

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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. J Pediatr (Rio J). 2009;85(4):329-334:Acquired immunodeficiency syndrome, lipodystrophy, dyslipidemias, pediatrics, antiretroviral agents. ResumoObjetivo: Avaliar a presença de lipodistrofia clínica em crianças com síndrome da imunodeficiência adquirida e relacioná-la com o esquema antirretroviral utilizado, alterações do perfil lipídico e resistência insulínica.Métodos: Por meio de estudo transversal, foram avaliadas 30 crianças e adolescentes (mediana de idade = 9,1 anos) com síndro-me da imunodeficiência adquirida, no período entre 2004 e 2005. As avaliações clínico-laboratoriais incluíram: classificação da infecção pelo HIV, medidas antropométricas (peso e estatura), glicemia e insulina séricas e perfil lipídico (LDL-c, HDL-c, triglicérides). A lipodistrofia foi definida por parâmetros clínicos. O teste do qui-quadrado foi utilizado na análise estatística.Resultados: Todos os pacientes recebiam terapia antirretroviral regularmente (mediana de tempo de uso = 28,4 meses), 80% utilizavam três drogas em associação (terapia fortemente ativa) e 30% usavam inibidores de protease. Lipodistrofia e dislipidemia foram observadas em 53,3 e 60% dos pacientes, respectivamente. Crianças que utilizavam ter...

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Section: Lipodistrofia Presente (N = 16) Lipodistrofia Ausente (N = 14)unclassified

Lipodystrophy in children and adolescents with acquired immunodeficiency syndrome and its relationship with the antiretroviral therapy employed

Sarni¹,

Souza²,

Battistini³

et al. 2009

J Pediatr (Rio J)

View full text Add to dashboard Cite

show abstract

“…23 A recent cohort study found that, after adjusted multifactorial analysis, there was a relationship between the use of protease inhibitors, the development of lipodystrophy and acute myocardial infarction in adults. 26 Human immunodeficiency virus infections can result in chronic oxidative stress with apoptosis of T-lymphocytes and increases in viral replication rates due to activation of nuclear factor kappa B.…”

Section: Discussionmentioning

confidence: 99%

“…The HIV infection itself is associated with a proatherogenic lipid profile characterized by increased triglycerides and a concentration of the lower density particles of the LDL fraction of cholesterol and a reduction in HDL C levels. 23,24 When compared with indinavir, nelfinavir and atazanavir, ritonavir is the protease inhibitor most associated with lipid profile abnormalities. 25 With relation to non-nucleoside reverse transcriptase, studies suggest that using nevirapine leads to fewer lipid profile abnormalities than efavirenz.…”

Section: Discussionmentioning

confidence: 99%