Hypertriglyceridemia and hypercholesterolemia in human immunodeficiency virus-1-infected children treated with protease inhibitors
Por:
Solórzano Santos F., Gochicoa Rangel L.G., Palacios Saucedo G., Vázquez Rosales G., Miranda Novales M.G.
Publicada:
1 ene 2006
Resumen:
Background. Adverse effects associated with highly active antiretroviral therapy (HAART), particularly protease inhibitors (PIs), have been identified in adult and pediatric patients. In this study, we monitored, for cholesterol and triglyceride levels, a cohort of HIV-1-infected children receiving a HAART regimen. Methods. HIV-infected patients <17 years old belonging to a cohort that has been followed since 1997 were enrolled in the study. Patients were receiving either a three- or four-drug antiretroviral regimen that included two nucleoside reverse transcriptase inhibitors (lamivudine and zidovudine) combined with one or two PIs (ritonavir and/or saquinavir). Cholesterol and triglyceride levels were measured on fasting serum samples drawn at the time of enrollment and every 3 months thereafter. Clinical evaluation was performed on a monthly basis. Methods. Twenty four patients were included. Median age at HIV infection diagnosis was 15 months. Twenty one patients received a four-drug antiretroviral regimen, while three patients received ritonavir plus zidovudine and lamivudine. Median follow-up was 27 months; 62.5% of patients had hypercholesterolemia and 79.2% had hypertriglyceridemia, most typically after 15 months of treatment. None of the patients had physical changes in body fat distribution suggesting lipodystrophy. Conclusions. Hyperlipidemia is a frequent complication in HIV-1-infected children undergoing antiretroviral treatment that includes PIs. Additional studies with larger cohorts and a longer follow-up are needed to propose a rationale and alternatives for patients who develop dyslipidemia while receiving PIs. © 2006 IMSS. Published by Elsevier Inc.
Filiaciones:
Solórzano Santos F.:
Infectious Diseases Department, Hospital de Pediatría, Instituto Mexicano del Seguro Social, México, D.F., Mexico
Av. Cuauhtemoc 330, Col. Doctores, México D.F., CP 06720, Mexico
Gochicoa Rangel L.G.:
Pediatrics Department, Hospital de Pediatría, Instituto Mexicano del Seguro Social, México, D.F., Mexico
Palacios Saucedo G.:
Infectious Diseases Department, Hospital de Pediatría, Instituto Mexicano del Seguro Social, México, D.F., Mexico
Vázquez Rosales G.:
Infectious Diseases Department, Hospital de Pediatría, Instituto Mexicano del Seguro Social, México, D.F., Mexico
Miranda Novales M.G.:
Infectious Diseases Department, Hospital de Pediatría, Instituto Mexicano del Seguro Social, México, D.F., Mexico
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