Body fat distribution in perinatally HIV-infected and HIV-exposed but uninfected children in the era of highly active antiretroviral therapy: outcomes from the Pediatric HIV/AIDS Cohort Study
Denise L Jacobson, Kunjal Patel, George K Siberry, Russell B Van Dyke, Linda A DiMeglio, Mitchell E Geffner, Janet S Chen, Elizabeth J McFarland, William Borkowsky, Margarita Silio, Roger A Fielding, Suzanne Siminski, Tracie L Miller, Pediatric HIV/AIDS Cohort Study, William Shearer, Norma Cooper, Lynette Harris, Murli Purswani, Mahboobullah Baig, Anna Cintron, Ana Puga, Sandra Navarro, Doyle Patton, Sandra Burchett, Nancy Karthas, Betsy Kammerer, Ram Yogev, Kathleen Malee, Scott Hunter, Eric Cagwin, Andrew Wiznia, Marlene Burey, Molly Nozyce, Janet Chen, Elizabeth Gobs, Mitzie Grant, Katherine Knapp, Kim Allison, Patricia Garvie, Midnela Acevedo-Flores, Heida Rios, Vivian Olivera, Margarita Silio, Medea Jones, Cheryl Borne, Patricia Sirois, Stephen Spector, Kim Norris, Sharon Nichols, Elizabeth McFarland, Emily Barr, Carrie Chambers, Jennifer Dunn, Douglas Watson, Nicole Messenger, Rose Belanger, Arry Dieudonne, Linda Bettica, Susan Adubato, Gwendolyn Scott, Lisa Himic, Elizabeth Willen, Andrea Desilets, Justin Wheeler, Denise L Jacobson, Kunjal Patel, George K Siberry, Russell B Van Dyke, Linda A DiMeglio, Mitchell E Geffner, Janet S Chen, Elizabeth J McFarland, William Borkowsky, Margarita Silio, Roger A Fielding, Suzanne Siminski, Tracie L Miller, Pediatric HIV/AIDS Cohort Study, William Shearer, Norma Cooper, Lynette Harris, Murli Purswani, Mahboobullah Baig, Anna Cintron, Ana Puga, Sandra Navarro, Doyle Patton, Sandra Burchett, Nancy Karthas, Betsy Kammerer, Ram Yogev, Kathleen Malee, Scott Hunter, Eric Cagwin, Andrew Wiznia, Marlene Burey, Molly Nozyce, Janet Chen, Elizabeth Gobs, Mitzie Grant, Katherine Knapp, Kim Allison, Patricia Garvie, Midnela Acevedo-Flores, Heida Rios, Vivian Olivera, Margarita Silio, Medea Jones, Cheryl Borne, Patricia Sirois, Stephen Spector, Kim Norris, Sharon Nichols, Elizabeth McFarland, Emily Barr, Carrie Chambers, Jennifer Dunn, Douglas Watson, Nicole Messenger, Rose Belanger, Arry Dieudonne, Linda Bettica, Susan Adubato, Gwendolyn Scott, Lisa Himic, Elizabeth Willen, Andrea Desilets, Justin Wheeler
Abstract
Background: Associations between abnormal body fat distribution and clinical variables are poorly understood in pediatric HIV disease.
Objective: Our objective was to compare total body fat and its distribution in perinatally HIV-infected and HIV-exposed but uninfected (HEU) children and to evaluate associations with clinical variables.
Design: In a cross-sectional analysis, children aged 7-16 y in the Pediatric HIV/AIDS Cohort Study underwent regionalized measurements of body fat via anthropometric methods and dual-energy X-ray absorptiometry. Multiple linear regression was used to evaluate body fat by HIV, with adjustment for age, Tanner stage, race, sex, and correlates of body fat in HIV-infected children. Percentage total body fat was compared with NHANES data.
Results: Males accounted for 47% of the 369 HIV-infected and 51% of the 176 HEU children. Compared with HEU children, HIV-infected children were older, were more frequently non-Hispanic black, more frequently had Tanner stage ≥3, and had lower mean height (-0.32 compared with 0.29), weight (0.13 compared with 0.70), and BMI (0.33 compared with 0.63) z scores. On average, HIV-infected children had a 5% lower percentage total body fat (TotF), a 2.8% lower percentage extremity fat (EF), a 1.4% higher percentage trunk fat (TF), and a 10% higher trunk-to-extremity fat ratio (TEFR) than did the HEU children and a lower TotF compared with NHANES data. Stavudine use was associated with lower EF and higher TF and TEFR. Non-nucleotide reverse transcriptase inhibitor use was associated with higher TotF and EF and lower TEFR.
Conclusion: Although BMI and total body fat were significantly lower in the HIV-infected children than in the HEU children, body fat distribution in the HIV-infected children followed a pattern associated with cardiovascular disease risk and possibly related to specific antiretroviral drugs.
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Source: PubMed