Impact of antiretroviral therapy on growth, body composition and metabolism in pediatric HIV patients

Roy J. Kim, Richard M. Rutstein

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Highly active antiretroviral therapy improves survival and growth in children with HIV infection. However, its use can be associated with adverse changes in body composition and metabolism. Bone mineral density can be adversely affected in HIV-positive children due to nutritional compromise or certain antiretrovirals. HIV-associated lipodystrophy, consisting of redistribution of adipose tissue, insulin resistance, and dyslipidemia, has also been described in children. Pediatric HIV patients may be at greater risk for these problems because of their longer potential lifetime exposure to these agents and because childhood is normally a period of rapid growth and tissue accretion. Healthcare providers for children with HIV infection must be aware of the potential complications associated with HIV antiretrovirals so that their antiviral efficacy can be balanced against their risk for side effects. In this review, we discuss the alterations in childhood growth and body composition that occur in HIV-infected children, and describe the impact of antiretroviral therapy on these outcomes. The problem of HIV-associated lipodystrophy syndrome in children is also discussed. Children with HIV should have their growth and body composition systematically monitored. Antiretroviral regimens should be tailored to optimize adherence and viral suppression while minimizing the potential for adverse side effects.

Original languageEnglish (US)
Pages (from-to)187-199
Number of pages13
JournalPediatric Drugs
Volume12
Issue number3
DOIs
StatePublished - 2010

Fingerprint

Body Composition
HIV
Pediatrics
Growth
HIV-Associated Lipodystrophy Syndrome
Therapeutics
HIV Infections
Highly Active Antiretroviral Therapy
Dyslipidemias
Health Personnel
Bone Density
Antiviral Agents
Insulin Resistance
Adipose Tissue
Survival

Keywords

  • Abacavir
  • Adolescents
  • Antiretrovirals
  • Body-composition
  • Children
  • Emtricitabine
  • Growth-disorders
  • HIV-1-infections
  • Infants
  • Lamivudine
  • Lipodystrophy
  • Metabolism
  • Non-nucleoside-reverse-transcriptase-inhibitors
  • Nucleoside-reverse-transcriptase-inhibitors
  • Peptide-hydrolase- inhibitors
  • Research-and-development
  • Ritonavir
  • Tenofovir
  • Therapeutic use
  • Treatment
  • Zidovudine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)

Cite this

Impact of antiretroviral therapy on growth, body composition and metabolism in pediatric HIV patients. / Kim, Roy J.; Rutstein, Richard M.

In: Pediatric Drugs, Vol. 12, No. 3, 2010, p. 187-199.

Research output: Contribution to journalArticle

Kim, Roy J. ; Rutstein, Richard M. / Impact of antiretroviral therapy on growth, body composition and metabolism in pediatric HIV patients. In: Pediatric Drugs. 2010 ; Vol. 12, No. 3. pp. 187-199.
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