Metabolic Syndrome in HIV Infected Children Receiving Free HAART at a Centre of Excellence in HIV Care in Northern India

Abstract

Objective: Children and adolescents infected with HIV through mother to child transmission are exposed to HIV related complications and anti-retroviral treatment adverse effects since conception and are more vulnerable to develop the metabolic complications. This study was carried out to assess the prevalence of metabolic syndrome and associated risk factors in HIV infected children aged 6-15 years using International Diabetes Federation (IDF) criteria. Methods: A total of 45 HIV infected children in the age group of 6-15 years were enrolled from the Anti-Retroviral Treatment Clinic of a tertiary care hospital in North India. Demographic details, clinical profile, immunological data and treatment details were obtained from clinic records. Anthropometric measurements recorded were weight, height, BMI, waist circumference. Biochemical parameters measured were fasting lipid profile (total cholesterol, triglycerides, HDL-C, LDL-C), blood sugar, serum insulin level and CD4+ cell count. Results: More than half of the participants were undernourished (57.7% had weight for age <-2z score). Most common metabolic abnormality noted was low HDL cholesterol levels (53.3%). 6.6% patients were noted to have insulin resistance. Significant association of protease inhibitor-based ART regimes with dyslipidemia was observed (p value=0.02). Metabolic syndrome could not be established in any participant as per the International Diabetes Federation (IDF) criteria since all had waist circumference less than the cut off range. Conclusion: Although full blown metabolic syndrome could not be established in the study population, significant metabolic derangements mainly dyslipidemia were noted in them even with concurrent malnutrition. Close monitoring and follow up for metabolic derangements and subsequent development of metabolic syndrome should be actively looked for in these children.