Document Detail


Longitudinal assessment of metabolic abnormalities in adolescents and young adults with HIV-infection acquired perinatally or in early childhood.
MedLine Citation:
PMID:  20947103     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Metabolic complications of HIV pose challenges for health maintenance among young adults who acquired HIV in early childhood. Between July 2004 and July 2009, we evaluated 47 HIV-infected subjects who acquired HIV in early life. Participants completed glucose tolerance testing; insulin, lipid, urine albumin, and creatinine determinations; and dual-energy x-ray absorptiometry scans. Longitudinal data were available for 39 subjects; duration of follow-up was 26.4 ± 16.8 months. At baseline, participants were 17.1 ± 3.9 years old; and duration of antiretroviral therapy was 12.7 ± 3.4 years. CD4 count was 658 ± 374 cells per cubic millimeter, and 55% had undetectable viral load. Impaired glucose tolerance was present in 15%; 33% had insulin resistance (homeostasis model assessment of insulin resistance >4.0). Furthermore, 52% had triglycerides of at least 150 mg/dL, 36% had high-density lipoprotein cholesterol less than 40 mg/dL, 18% had low-density lipoprotein cholesterol of at least 130 mg/dL, and 25% had total cholesterol of at least 200 mg/dL. Microalbuminuria was present in 15% of participants and was inversely correlated with CD4% (P = .001). During follow-up, more than one third remained insulin resistant; lipid parameters tended to improve. There were significant increases in body mass index (P = .0002), percentage leg fat (P = .008), and percentage trunk fat (P = .002). Impaired glucose tolerance, insulin resistance, dyslipidemia, and microalbuminuria are common among young adults with HIV. Long-term exposure to therapy may translate into substantial persistent metabolic risk.
Authors:
David Dimock; Vijaya Thomas; Anna Cushing; Julia B Purdy; Carol Worrell; Jeffrey B Kopp; Rohan Hazra; Colleen Hadigan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural     Date:  2010-10-13
Journal Detail:
Title:  Metabolism: clinical and experimental     Volume:  60     ISSN:  1532-8600     ISO Abbreviation:  Metab. Clin. Exp.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-17     Completed Date:  2011-07-19     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0375267     Medline TA:  Metabolism     Country:  United States    
Other Details:
Languages:  eng     Pagination:  874-80     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Inc.
Affiliation:
Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.
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MeSH Terms
Descriptor/Qualifier:
Absorptiometry, Photon
Adolescent
Albuminuria / etiology
Anthropometry
Antiretroviral Therapy, Highly Active / adverse effects*
Body Composition / physiology
Body Mass Index
Cardiovascular Diseases / prevention & control
Carotid Artery Diseases / chemically induced,  pathology
Cross-Sectional Studies
Female
Follow-Up Studies
Glucose Tolerance Test
HIV Infections / complications*,  etiology,  metabolism
Humans
Infant
Infant, Newborn
Insulin / blood
Insulin Resistance / physiology
Lipid Metabolism Disorders / chemically induced,  metabolism
Lipodystrophy / chemically induced,  etiology
Longitudinal Studies
Male
Metabolic Diseases / chemically induced,  etiology*,  metabolism
Puberty
Risk Reduction Behavior
Young Adult
Grant Support
ID/Acronym/Agency:
Z99 AI999999/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Insulin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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