Back
 OJPed  Vol.5 No.3 , September 2015
Lipodystrophy among Children Infected with Human Immunodeficiency Virus and on Antiretroviral Treatment in Ouagadougou
Abstract: Management of Human Immunodeficiency Virus infection remains a major challenge in many sub-Saharan African countries. Antiretroviral drugs which have reduced significantly the mortality rate of this pandemic disease are a source of side effects. Among these side effects, adult lipodystrophy has already been described by several authors. The aim of this study is to determine the prevalence of lipodystrophy and associate factors in children on antiretroviral therapy, managed at Charles De Gaulle Children University Hospital and Yalgado Ouedrago University Hospital in Ouagadougou, Burkina Faso. This is a cross-sectional study conducted from June 2013 to January 2014. We included children aged 2 to 15 years who had been on antiretroviral treatment for at least six months with no severe acute malnutrition (wasting). Lipodystrophy was diagnosed clinically after assessment of morphological changes. Overall, 323 children complying with the inclusion criteria were examined. The average duration of antiretroviral therapy was 5.3 years. Forty five children had lipodystrophy, i.e. 13.9% prevalence rate. One hundred and twenty seven different lipodystrophic lesions were noted, hence 82.7% lipoatrophy and 17.3% lipohypertrophy. The most common presentations were: face (32%), lower limbs (26%) and upper limbs (15.7%). Factors associated with lipoatrophy were: age above 10 years (P = 0.004); male gender (P = 0.0004); antiretroviral treatment duration of more than 60 months (P < 0.001) and treatment with stavudine (P = 0.01). Our study showed that lipodystrophy is not exceptional in children on antiretroviral therapy in Ouagadougou. However, more researches on lipid profiles of these children are necessary to prevent other common complications related to fat accumulation.
Cite this paper: Yonaba, C. , Ouedraogo, A. , Ouédraogo, S. , Ouattara, B. , Kalmogho, A. , Koueta, F. , Yé, D. and Kam, L. (2015) Lipodystrophy among Children Infected with Human Immunodeficiency Virus and on Antiretroviral Treatment in Ouagadougou. Open Journal of Pediatrics, 5, 199-206. doi: 10.4236/ojped.2015.53030.
References

[1]   Mutimura, E., Stewart, A. and Crowther, N.J. (2007) Assessment of Quality of Life in HAART-Treated HIV-Positive Subjects with Body Fat Redistribution in Rwanda. AIDS Research and Therapy, 4, 19.
http://dx.doi.org/10.1186/1742-6405-4-19

[2]   Capeau, J., Caron, M., Vigouroux, C., Carvera, P., Kim, M., Maachi, M., et al. (2006) Les lipodystrophy secondaires aux traitements ARV de l’infection par le VIH. Médecine Sciences, 22, 531-536.
http://dx.doi.org/10.1051/medsci/2006225531

[3]   Mercier, S., Gueye, N.F.N., Cournil, A., Fontbonne, A., Copin, N., Ndiaye, I., et al. (2009) Lipodystrophy and Metabolic Desorders in HIV-1-Infected Adults on 4- to 9-Year Antiretroviral Therapy in Senegal: A Case Control Study. Journal of Acquired Immune Deficiency Syndromes, 51, 224-230.
http://dx.doi.org/10.1097/QAI.0b013e31819c16f4

[4]   Thiébaut, R., Daucourt, V., Mercié, P., Ekouévi, D.K., Malvy, D., Morlat, P., et al. (2000) Lipodystrophy, Metabolic Disorders, and Human Immunodeficiency Virus Infection: Aquitaine Cohort. Clinical Infectious Diseases, 31, 1482-1487.
http://dx.doi.org/10.1086/317477

[5]   Aurpibul, L., Puthanakit, T., Lee, B., Mangtaburks, A., Sirisanthana, T. and Sirisanthana, V. (2007) Lipodystrophy and Metabolic Changes in HIV-Infected Children on Non-Nucleoside Reverse Transcriptase Inhibitor-Based Antiretroviral Therapy. Antiviral Therapy, 12, 1247-1254.

[6]   Capeau, J. and Valantin, M.-A. (2011) Syndrome lipodystrophique au cours du traitement antirétroviral in HIV; édition doin. 525-540.

[7]   Chironi, G., Simon, A. and Vittecoq, D. (2004) Le risque cardiovasculaire au cours des traitements ARV, effets indésirables et alternatives thérapeutiques. Médecine Thérapeutique, 10, 120-128.

[8]   Lapphra, K., Vanprapar, N., Phongsmart, W., et al. (2005) Dyslipidemia and Lipodystrophy in HIV-Infected Thai Children on Highly Active Antiretroviral Therapy (HAART). Journal of the Medical Association of Thailand, 88, 956-965.

[9]   Hammond, E. and Noland, D. (2007) Adipose Tissue Inflammation and Altered Adipokine and Cytokine Production. Antiretroviral Therapy-Associated Lipodystrophy, 2, 274-281.

[10]   Dollfus, C., Jaquet, D., Levine, M., Ortoga-Rodriguez, E., Faye, A., Polak, M., et al. (2000) Clinical and Metabolic Presentation of the Lipodystrophic Syndrome in HIV-Infected Children. AIDS, 14, 2123-2128.
http://dx.doi.org/10.1097/00002030-200009290-00008

[11]   Piloya, T., Bakeera-Kitaka, S., Kekitiinwa, A. and Kamya, M.R. (2012) Lipodystrophy among HIV-Infected Children and Adolescents on Highly Active Antiretroviral Therapy in Uganda: A Cross Sectional Study. Journal of International AIDS Society, 15, 17427.
http://dx.doi.org/10.7448/IAS.15.2.17427

[12]   European Paediatric Lipodystrophy Group (2004) Antiretroviral Therapy, Fat Redistribution and Hyperlipidaemia in HIV-Infected Children in Europe. AIDS, 18, 1443-1435.
http://dx.doi.org/10.1097/01.aids.0000131334.38172.01

[13]   Joly, V., Flandre, P., Meiffredy, V., Leturgue, N., Harel, M., Aboulker, J.P., et al. (2002) Increased Risk of Lipoatrophy under Stavudine in HIV-1-Infected Patients: Results of a Substudy from a Comparative Trial. AIDS, 16, 2447-2454.
http://dx.doi.org/10.1097/00002030-200212060-00010

[14]   Ministère de la santé du Burkina Faso (2009) Comité ministériel de lutte contre le VIH/SIDA au Burkina Faso, normes et protocoles de prise en charge médicale des personnes vivant avec le VIH au Burkina Faso. 200 p.

[15]   Vigano, A., Mora, S., Testolin, C., Beccio, S., Schneider, L., Bricalli, D., et al. (2003) Increased Lipodystrophy Is Associated with Increased Exposure to HAART in HIV-Infected Children. Journal of AIDS, 32, 482-489.
http://dx.doi.org/10.1097/00126334-200304150-00003

[16]   WHO (2014) Antiretroviral Therapy for HIV Infection in Infants and Children.
http://www.who.int/hiv/pub/paediatric/infants2010/en/

[17]   Kinabo, G.D., Sprengers, M., Msuya, L.J., Shayo, A.M., Van Asten, H., Dolmans, W.M., et al. (2012) Prevalence of Lipodystrophy in HIV-Infected Children in Tanzania on Highly Active Antiretroviral Therapy. The Pediatric Infectious Disease Journal, 32, 39-44.

[18]   Hartman, K., Verweel, G., Groot, R. and Hartwig, N.G. (2006) Detection of Lipoatrophy in Human Immunodeficiency Virus-1-Infected Children Treated with HAART. The Pediatric Infectious Disease Journal, 25, 427-431.
http://dx.doi.org/10.1097/01.inf.0000215003.32256.aa

[19]   Padilla, S., Gallego, J.A., Masia, M. and Gutierrez, F. (2004) Single-Slice Computed Tomography and Antropometric Skinfold Analysis for Evaluation of Facial Lipoatrophy in HIV-Infected Patients. Clinical Infectious Diseases, 39, 1848-1851.
http://dx.doi.org/10.1086/426072

[20]   Levan, P., Nguyen, T.H., Lallemand, F., Mazetier, L., Mimoun, M., Rozenbaum, W., et al. (2002) Correction of Facial Lipoatrophy, in HIV-Infected Patients on HAART by Injection of Autologous Fatty Tissue. AIDS, 16, 1985-1987.
http://dx.doi.org/10.1097/00002030-200209270-00026

 
 
Top