Background: Life expectancy of children with human immunodeficiency virus (HIV) has increased due to highly active antiretroviral therapy. Metabolic disorders and changes in bone mineral density (BMD) are common in adult patients with HIV. There are few studies evaluating metabolic and bone involvement in children.
Objective and hypotheses: To evaluate metabolic disorders and BMD in vertically HIV-infected children in four Chilean hospitals.
Method: A total of 68 children with HIV were studied (35 women), 12.2 years (3.818.5). We determined disease stage, zBMI, zHeight, vitamin D levels and BMD. Energy, protein and calcium intake were recorded. Spearman and partial correlations were used.
Results: 5-13-4-23-4-1-11-4 and 3 patients were in stage N1, A1, A2, B1, B2, B3, C1, C2 and C3 respectively. 68% were normal weight (46/68), 7% underweight, 18% overweight and 6% obese. 49% (32/66) had body fat >30%, 44% (26/59) elevated triglycerides, 22% had a height/age <−2 SD. Vitamin D levels were <20 ng/ml in 28% of patients, 30% between 20 and 30 ng/ml. Spine BMD was <−1.5 SD in 16% (11/68) and 7.3% (5/68) <−2 SD. Hip BMD was <−1.5 SD in 2% (2/68) and 6% (4/68) <−2 SD. All patients consumed about 2.5 times their protein requirements, 27 and 68 <75% of their energy and calcium requirements. Significant correlations were found between BMD and zheight, zBMI, CDC disease classification at diagnosis r<0.26 (P<0.05), Current classification r<0.3 (P<0.01), worst CDC classification presented r<0.3 (P<0.05), and years of treatment r<0.4 (P<0.01).
Conclusion: Paediatric patients with vertically HIV infection have a high percentage of body fat mass and altered triglycerides and bone involvement correlated with disease severity. This would increase the risk of chronic diseases in adulthood.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology