Keywords
triglycerides
protease inhibitor
pediatric
How to Cite
Abstract
Introduction: Human immunodeficiency virus (HIV) infection and antiretroviral treatment are associated with biochemical and metabolic changes, including modifications in the lipid profiles. Objective: To describe the changes in triglyceride levels caused by the antiretroviral treatment plus a protease inhibitor, and its long-term effects on these levels. Materials and methods: HIV-positive patients followed at Pedro de Elizalde Children’s Hospital, Buenos Aires, Argentina, who presented triglyceride levels higher than the reference value (150 mg/ dl) at some moment of the infection, were retrospectively studied. Triglycerides, CD4+ T cells and viral load levels, before and after protease inhibitor incorporation, were recorded. Results: Twenty-six of the patients who met the inclusion criteria presented CD4+ T cells and viral load levels in a wide range of variability, without significant differences between the moments evaluated. Triglyceride values presented a significant increase in 88% of the patients. A significant increase was also observed in the groups with moderate or severe immunosuppression (median: 150 mg/dl, range: 54-266 mg/dl and 332 mg/dl, 76-938 mg/dl). Seven out of eight patients studied in long-term follow-up presented triglyceride mean values greater than 150 mg/dl (range 185- 348 mg/dl).
References
Zhou DT, Nehumba D, Oktedalen O, Marange P, Kodogo V, Gomo ZA, et al. Changes in Lipid Profiles of HIV + Adults over Nine Months at a Harare HIV Clinic : A Longitudinal Study. Biochem Res Int [Internet]. 2016;7. Disponible en: http://dx.doi.org/10.1155/2016/3204818
Kotler DP. HIV and antiretroviral therapy: lipid abnormalities and associated cardiovascular risk in HIV-infected patients. J Acquir Immune Defic Syndr. 2008;49 Suppl 2:79-85.
Leth F Van, Phanuphak P, Stroes E, Gazzard B, Cahn P, Wood R, et al. Nevirapine and Efavirenz Elicit Different Changes in Lipid Profiles in Antiretroviral-Therapy-Naive Patients Infected with HIV-1. PLoS Med. 2004;1(1):64-74.
Sprinz E, Lazzaretti RK, Kuhmmer R, Ribeiro JP. Dyslipidemia in HIVinfected individuals. Brazilian J Infect Dis. 2010;14(6):575-88.
Cunha J da, Morganti Ferreira Maselli L, Bassi Stern AC, Spada C, Bydlowski SP. Impact of antiretroviral therapy on lipid metabolism of human immunodeficiency virus-infected patients: Old and new drugs. World J Virol. 2015;4(2):56-77.
Tadesse BT, Foster BA, Chala A, Chaka TE, Bizuayehu T, Ayalew F, et al. HIV and cART-Associated Dyslipidemia Among HIV-Infected Children. J Clin Med. 2019;8(4):430-442.
OPS/OMS OP de la S. Definición de caso de la OMS de la infección por el VIH a efectos de vigilancia [Internet]. Organizacion Panamericana de salud [OPS]. 2009. 15-20 p. Disponible en: http://www1.paho.org/hq/dmdocuments/2009/DEFINICION_ESTADIFICACION2.pdf
Schneider E, Whitmore S, Glynn K, Dominguez K, Mitsch A, McKenna M. Revised Surveillance Case Definitions for HIV Infection Among Adults, Adolescents, and Children Aged <18 Months and for HIV Infection and AIDS Among Children Aged 18 Months to <13 Years. MMWR. 2008;57(RR10):1-8.
Dybul M, Fauci A, Bartlett J, Kaplan J, Pau A. Guidelines for Using Antiretroviral Agents Among HIV-Infected Adults and Adolescents. MMWR. 2002;51(RR07):1.
Children M of the WG on AT and MM of H-I. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. MMWR. 1998;47(RR4):1-31.
Classification R. 1994 Revised Classification System for Human Immunodeficiency Virus Infection in Children Less Than 13 Years of Age. Arch Dermatol. 1994;130(12):1485-6.
Lafeuillade A, Wainberg M, Gougeon M, Loes SK, Halfon P. Highlights from the 2014 International Symposium on HIV & Emerging Infectious Diseases ( ISHEID ): from cART management to the end of the HIV pandemic. AIDS Res Ther. 2014;11(28):1-8.
. Andrade Ruiz MA, Andrade Ruiz HA. Alteraciones del metabolismo lipídico en pacientes seropositivos para VIH con tratamiento retroviral altamente efectivo. Rev Cuba Cardiol y Cirugía Cardiovasc. 2010;16(1):64-73.
Riddler SA, Cole SR, Chmiel JS, Dobs A, Palella F, Kingsley LA. Impact of HIV Infection and HAART on Serum Lipids in Men. JAMA.2003;289(22):2978-82.
Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:21-30.
Paintsil E. Monitoring antiretroviral therapy in HIV-infected children in resource-limited countries: A tale of two epidemics. AIDS Res Treat. Volumen 2011, ID del artículo: 280901, 9 páginas.
Calza L, Manfredi R, Chiodo F. Hyperlipidaemia in patients with HIV-1 infection receiving highly active antiretroviral therapy: Epidemiology, pathogenesis, clinical course and management. Int J Antimicrob Agents. 2003;22(2):89-99.