NUTRITION, PHYSICAL ACTIVITY AND SARCOPENIA IN THE ELDERLY
Location: Human Nutrition Research Center on Aging
Title: 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
| Jacobson, Denise L. - |
| Patel, Kunjal - |
| Siberry, George K. - |
| Van Dyke, Russell B. - |
| Dimeglio, Linda A. - |
| Geffner, Mitchell E. - |
| Chen, Janet S. - |
| Mcfarland, Elizabeth J. - |
| Borkowsky, William - |
| Silio, Margarita - |
| Fielding, Roger A. - |
| Siminski, Suzanne - |
| Miller, Tracie L. - |
Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: September 13, 2011
Publication Date: December 1, 2011
Citation: Jacobson, D., Patel, K., Siberry, G., Van Dyke, R., Dimeglio, L., Geffner, M., Chen, J., Mcfarland, E., Borkowsky, W., Silio, M., Fielding, R., Siminski, S., Miller, T. 2011. 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. American Journal of Clinical Nutrition. 92(6):1485-1495.
Interpretive Summary: Abnormal body fat distribution is a consequence of childhood HIV infection. It is unclear if this abnormal distribution is a consequence of the actual HIV infection or a product of the potent drug regimens used to keep the virus in check (anti-retroviral therapy). Children aged 7-16 years in the Pediatric HIV/AIDS Cohort (PHACS) Study were evaluated for their body fat distribution and quantity. We compared HIV-infected (HIV) and HIV-exposed, uninfected (HEU) children. HIV had 5% lower percent body fat, 2.6% lower percent extremity fat (EF), 1.4% higher percent trunk fat (TF), and 10% higher trunk-to-extremity fat ratio (TEFR) than HEU. Although HIV-infected children had a significantly lower BMI and total body fat than HEU, their body fat distribution followed a pattern associated with increased cardiovascular risk.
Associations between abnormal body fat distribution and clinical variables are poorly understood in pediatric HIV disease. 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. 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. 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 (20.32 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. 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.