Alterações no metabolismo lipídico e glicídico de crianças portadoras de HIV/aids atendidas na Unidade Mista de Saúde da Regional Sul (Hospital Dia) no Distrito Federal, Brasil

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

The implementation of Highly Active Antiretroviral Therapy (HAART) in combination regimens has profoundly decreased mortality and disease progression in children infected with the human immunodeficiency virus. These, however, are more vulnerable for the adverse effects of the therapy because they must be treated for a long time. The metabolic effects of the infection and of HAART had been assessed in a few paediatric studies. This study had the objective of evaluate disorders in lipid metabolism as in the metabolism of glucose in children with HIV/aids, that were followed in the Health Mixed Unit of South Region of Health State Secretariat at Federal District, in the period from June to December of 2005. It was a sectional study. It was reported the main alterations finded and it was evaluated the prevalence of lipodystrophy. It was evaluated 60 children from 18 months until 12 years old, infected with HIV or with aids, after the free informed consent accord of their responsible person. The lipodystrophy definition involved only physical alterations, without considering presence of dyslipidemias. Fasting serum concentrations of total cholesterol, HDL, LDL, triglycerides, glucose and insulin were measured. It was also performed nutritional evaluation measuring weight, height, body mass index, triceps and subscapular skinfolds, that were compared with the National Center for Health Statistics, to analyse the nutritional classification of the child. The patients who had abnormalities in their tests were leaded for an Endocrinology Service in the Regional Hospital of South Region, to be followed. Our sample had similar distribution by gender and the mean of age was 7,52, standard deviation of 2,71. Half of the children had cholesterol levels higher than 170 mg/dl, 46,8% of them had LDL ≥ 110 mg/dl, 56 % had abnormal triglycerides for their age, 3,3% had fasting glucose ≥100 mg/dl and all of children had normal insulin values. According to the Gomez classification, 41,7% of children were malnourished. According to the body mass index classification, 60% of children were eutrophic ,15% had risk of low weight, 11,7% had low weight, 6,7% had counterweight and 6,7% had obesity. The prevalence of lipodystrophy was 3.3%. 16,7% of children had all of the lipid values altered and 86,7% had at least one lipid value altered. The fasting glucose was also altered and we showed an insulin resistance tendency. There was an elevation of the levels of cholesterol, LDL and triglycerides, and a decrease in HDL in children that used protease inhibitors. Almost all of the children that used Lopinavir/ritonavir or ritonavir had alteration in at least one value of the lipid profile. Prospective studies are essential to evaluate the impact of these alterations on the cardiovascular risk of these children.

ASSUNTO(S)

metabolic disturbs hiv/aids aids (doença) - pacientes - crianças lipodystrophy terapia antiretroviral altamente potente children haart hospitais lipodistrofia medicina hiv (doença) - pacientes - crianças alterações metabólicas distrito federal (brasil)

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