Prevalence of Lipodystrophy in HIV-infected Children in Tanzania on Highly Active Antiretroviral Therapy

Grace D. Kinabo, Mirte Sprengers, Levina J. Msuya, Aisa M. Shayo, Henri van Asten, Wil M. V. Dolmans, Andre J. A. M. van der Ven, Adilia Warris

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE: Highly active antiretroviral therapy (HAART) has been associated with lipodystrophy (LD) in adults but data are more limited for children. The purpose of this study was to determine the prevalence of and risk factors for LD in Tanzanian children receiving HAART by clinical assessment and to compare the results with anthropometric data.

DESIGN AND METHODS: A cross-sectional study was performed in a cohort of HIV-infected children aged 1-18 years receiving HAART in a single center in Moshi, Tanzania. Age, gender, past and current medication regimens and anthropometric measurements were recorded. A clinical scoring method was used to assess LD. Backward binary multivariate logistic regression was used to determine relationships between anthropometric measurements and the presence of clinical LD.

RESULTS: Among 210 HIV-infected children, the prevalence of LD was 30% (95% confidence interval [CI]: 23.8-36.2) overall, 19% (95% CI: 13.7-24.3) for lipoatrophy only, 3.8% (95% CI: 1.2-6.4) for lipohypertrophy only and 7.1% (95% CI: 3.6-10.6) for the mixed type. Most cases were mild. Older age and use of stavudine increased the risk of LD. Overall, the study population was stunted but not underweight. In children with relatively lower weight-for-height (<1), only the mid-upper arm circumference was found to be associated with lipoatrophy, while nearly all anthropometric measurements were associated with lipoatrophy in the well-nourished (weight-for-height ≥1) children.

CONCLUSIONS: Our findings demonstrate that LD is a significant problem among Tanzanian HIV-infected children receiving HAART. Anthropometric measurements predicted LD in well-nourished children but generally failed to do so in relatively wasted children. Our findings support current efforts to avoid stavudine use in children.

Original languageEnglish
Pages (from-to)39-44
Number of pages6
JournalPediatric Infectious Disease Journal
Volume32
Issue number1
DOIs
Publication statusPublished - Jan 2013

Fingerprint

Lipodystrophy
Tanzania
Highly Active Antiretroviral Therapy
HIV
Confidence Intervals
Stavudine
Weights and Measures
Thinness
Arm
Research Design
Cross-Sectional Studies
Logistic Models

Keywords

  • lipodystrophy
  • anthropometry
  • pediatrics
  • highly active antiretroviral therapy
  • HIV

Cite this

Kinabo, G. D., Sprengers, M., Msuya, L. J., Shayo, A. M., van Asten, H., Dolmans, W. M. V., ... Warris, A. (2013). Prevalence of Lipodystrophy in HIV-infected Children in Tanzania on Highly Active Antiretroviral Therapy. Pediatric Infectious Disease Journal, 32(1), 39-44. https://doi.org/10.1097/INF.0b013e3182755a34

Prevalence of Lipodystrophy in HIV-infected Children in Tanzania on Highly Active Antiretroviral Therapy. / Kinabo, Grace D.; Sprengers, Mirte; Msuya, Levina J.; Shayo, Aisa M.; van Asten, Henri; Dolmans, Wil M. V.; van der Ven, Andre J. A. M.; Warris, Adilia.

In: Pediatric Infectious Disease Journal, Vol. 32, No. 1, 01.2013, p. 39-44.

Research output: Contribution to journalArticle

Kinabo, GD, Sprengers, M, Msuya, LJ, Shayo, AM, van Asten, H, Dolmans, WMV, van der Ven, AJAM & Warris, A 2013, 'Prevalence of Lipodystrophy in HIV-infected Children in Tanzania on Highly Active Antiretroviral Therapy', Pediatric Infectious Disease Journal, vol. 32, no. 1, pp. 39-44. https://doi.org/10.1097/INF.0b013e3182755a34
Kinabo, Grace D. ; Sprengers, Mirte ; Msuya, Levina J. ; Shayo, Aisa M. ; van Asten, Henri ; Dolmans, Wil M. V. ; van der Ven, Andre J. A. M. ; Warris, Adilia. / Prevalence of Lipodystrophy in HIV-infected Children in Tanzania on Highly Active Antiretroviral Therapy. In: Pediatric Infectious Disease Journal. 2013 ; Vol. 32, No. 1. pp. 39-44.
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AU - Kinabo, Grace D.

AU - Sprengers, Mirte

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AU - Shayo, Aisa M.

AU - van Asten, Henri

AU - Dolmans, Wil M. V.

AU - van der Ven, Andre J. A. M.

AU - Warris, Adilia

N1 - The authors thank Sr. M. Mushi, E. Matijyo, S. Silayo and A. Makundi for reviewing and enrolling study participants; and Edwiga and Ndosa for their assistance in retrieving medical charts. The authors are grateful to the patients and clinicians of the CCFCC-KCMC for their contributions.

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N2 - OBJECTIVE: Highly active antiretroviral therapy (HAART) has been associated with lipodystrophy (LD) in adults but data are more limited for children. The purpose of this study was to determine the prevalence of and risk factors for LD in Tanzanian children receiving HAART by clinical assessment and to compare the results with anthropometric data.DESIGN AND METHODS: A cross-sectional study was performed in a cohort of HIV-infected children aged 1-18 years receiving HAART in a single center in Moshi, Tanzania. Age, gender, past and current medication regimens and anthropometric measurements were recorded. A clinical scoring method was used to assess LD. Backward binary multivariate logistic regression was used to determine relationships between anthropometric measurements and the presence of clinical LD.RESULTS: Among 210 HIV-infected children, the prevalence of LD was 30% (95% confidence interval [CI]: 23.8-36.2) overall, 19% (95% CI: 13.7-24.3) for lipoatrophy only, 3.8% (95% CI: 1.2-6.4) for lipohypertrophy only and 7.1% (95% CI: 3.6-10.6) for the mixed type. Most cases were mild. Older age and use of stavudine increased the risk of LD. Overall, the study population was stunted but not underweight. In children with relatively lower weight-for-height (<1), only the mid-upper arm circumference was found to be associated with lipoatrophy, while nearly all anthropometric measurements were associated with lipoatrophy in the well-nourished (weight-for-height ≥1) children.CONCLUSIONS: Our findings demonstrate that LD is a significant problem among Tanzanian HIV-infected children receiving HAART. Anthropometric measurements predicted LD in well-nourished children but generally failed to do so in relatively wasted children. Our findings support current efforts to avoid stavudine use in children.

AB - OBJECTIVE: Highly active antiretroviral therapy (HAART) has been associated with lipodystrophy (LD) in adults but data are more limited for children. The purpose of this study was to determine the prevalence of and risk factors for LD in Tanzanian children receiving HAART by clinical assessment and to compare the results with anthropometric data.DESIGN AND METHODS: A cross-sectional study was performed in a cohort of HIV-infected children aged 1-18 years receiving HAART in a single center in Moshi, Tanzania. Age, gender, past and current medication regimens and anthropometric measurements were recorded. A clinical scoring method was used to assess LD. Backward binary multivariate logistic regression was used to determine relationships between anthropometric measurements and the presence of clinical LD.RESULTS: Among 210 HIV-infected children, the prevalence of LD was 30% (95% confidence interval [CI]: 23.8-36.2) overall, 19% (95% CI: 13.7-24.3) for lipoatrophy only, 3.8% (95% CI: 1.2-6.4) for lipohypertrophy only and 7.1% (95% CI: 3.6-10.6) for the mixed type. Most cases were mild. Older age and use of stavudine increased the risk of LD. Overall, the study population was stunted but not underweight. In children with relatively lower weight-for-height (<1), only the mid-upper arm circumference was found to be associated with lipoatrophy, while nearly all anthropometric measurements were associated with lipoatrophy in the well-nourished (weight-for-height ≥1) children.CONCLUSIONS: Our findings demonstrate that LD is a significant problem among Tanzanian HIV-infected children receiving HAART. Anthropometric measurements predicted LD in well-nourished children but generally failed to do so in relatively wasted children. Our findings support current efforts to avoid stavudine use in children.

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