Low prevalence of lipodystrophy in HIV-infected Senegalese children on long-term antiretroviral treatment: the ANRS 12279 MAGGSEN Pediatric Cohort Study

Abstract

Lipodystrophy diagnosis involves changes in regional fat distribution, including peripheral fat loss (lipoatrophy), central fat accumulation (lipohypertrophy), or a combination of both. Because lipodystrophy, and in particular the potentially disfiguring effects of lipoatrophy, may negatively affect treatment adherence and effectiveness [1], such effects are of major concern in children and adolescents who may require life-long ART. [...]lipodystrophy development is likely multifactorial, including other risk factors, such as puberty [5, 6, 13], ethnicity [2, 3], HIV disease progression [3, 8] and host factors [14]. [...]due to the small number of fat redistribution cases, a limited number of explanatory variables could be included in the multivariable model and statistical power might be limited. The responsiveness of the national Senegalese HIV programme to the 2007 WHO recommendations to phase out stavudine due to concerns over treatment toxicity, presumably helped to prevent the occurrence and/or the progression of lipodystrophy in these HIV-infected children and adolescents. [...]we found that consistent exposure to lopinavir/r and zidovudine did not lead to such adverse drug reaction in our cohort.