{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:06:03Z","timestamp":1791198363389,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,7,2]],"date-time":"2012-07-02T00:00:00Z","timestamp":1341187200000},"content-version":"vor","delay-in-days":92,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>With widespread use of antiretroviral therapy (ART) and prolonged survival of HIV\u2010infected children, toxicities like lipodystrophy are becoming more evident. Little is known about lipodystrophy in children in Uganda yet there is increased use of ART. The aim of this study was to determine the prevalence and factors associated with fat redistribution and metabolic abnormalities among HIV\u2010infected children on highly active antiretroviral therapy (HAART) in Uganda.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study of 364 HIV positive children aged between 2 and 18 years on ART were enrolled after consent and assent as appropriate. Sociodemographic, clinical and immunological data were collected and recorded in a questionnaire. Fat redistribution was assessed clinically for physical findings of lipohypertrophy and lipoatrophy. A fasting blood sample was taken for lipid profile and blood glucose analysis. Lipodystrophy was defined as presence of abnormal fat redistribution or metabolic abnormalities or both. The proportion of children with fat redistribution and metabolic abnormalities was calculated. We conducted multivariate analysis for factors associated with lipodystrophy among children with lipodystrophic features and those without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of the participants was eight years (range 2 to 18), with 43% of these aged \u226510 years and a male to female ratio of 1.1:1. Majority (65%) had advanced HIV (WHO Stage III\/IV) at ART initiation with a mean duration on ART of 3.8 years (\u00b11.2). The prevalence of fat redistribution and hyperlipidemia was 27.0% and 34.0%, respectively. None of the children had hyperglycaemia. Among the children with hyperlipidemia, 16.8% exhibited hypercholesterolemia and 83% had hypertriglyceridemia. Only 29% of children with fat redistribution had hyperlipidemia. We found significant association between fat redistribution and Tanner stages 2 to 5 OR=2.3 (95%CI 1.3 to 3.8), age\u22655 years OR=3.9 (95%CI 1.5 to 9.9) and d4T exposure OR=3.4 (95%CI 2.0 to 5.8). A Tanner stage 2 to 5 was independently associated with hyperlipidemia. No significant association was observed with HIV clinical stage and any of the anthropometric measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The prevalence of lipodystrophy is high among HIV\u2010infected children on ART with a likelihood of developing fat redistribution and metabolic abnormalities increased during puberty.<\/jats:p><\/jats:sec>","DOI":"10.7448\/ias.15.2.17427","type":"journal-article","created":{"date-parts":[[2012,7,3]],"date-time":"2012-07-03T03:50:07Z","timestamp":1341287407000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Lipodystrophy among HIV\u2010infected children and adolescents on highly active antiretroviral therapy in Uganda: a cross sectional study"],"prefix":"10.1002","volume":"15","author":[{"given":"Thereza","family":"Piloya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Bakeera\u2010Kitaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeodata","family":"Kekitiinwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses R","family":"Kamya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,7,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02854-3"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06413-3"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200301000-00018"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200205000-00011"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)05754-7"},{"key":"e_1_2_11_7_1","first-page":"1443","article-title":"European Paediatric Lipodystrophy Group","volume":"18","author":"Vigan\u00f2 A","year":"2004","journal-title":"Antiretroviral therapy, fat redistribution and hyperlipidaemia in HIV\u2010infected children in Europe"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-004-1610-y"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-006-0193-1"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","unstructured":"InnesS LeonL CottonM.Lipodystrophy syndrome in HIV infected children on HAART.South Afr J HIV Med.2009:76\u201380.","DOI":"10.4102\/sajhivmed.v10i4.264"},{"key":"e_1_2_11_11_1","volume-title":"National antiretroviral treatment and care guidelines for adults and children","author":"Ministry of Health, Uganda","year":"2008"},{"key":"e_1_2_11_12_1","volume-title":"Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach, 2006 revision [cited 2008 August 15]","author":"UNAIDS\/WHO","year":"2006"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030218"},{"key":"e_1_2_11_14_1","unstructured":"El\u2010SadrW ReissP De WitS.Relationship between prolonged exposure to combination ART and myocardial infarction: effect of sex age and lipid changes.12th Conference on Retroviruses and Opportunistic Infections; February 2005; Boston USA. (Abstract 42)"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00126334-200212153-00011"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)62067-5"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)08468-2"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000215003.32256.aa"},{"key":"e_1_2_11_19_1","first-page":"41","article-title":"Fat redistribution and metabolic disturbances in HIV\u2010infected children and adolescents under highly active antiretroviral therapy (HAART)","volume":"66","author":"Mar\u00eda RM","year":"2009","journal-title":"Bol Med Hosp Infant Mex"},{"key":"e_1_2_11_20_1","unstructured":"ViganoA ThorneC.European Collaborative Study.Italian register on HIV in children. Fat redistribution and metabolic abnormalities in HIV\u2010infected children and adolescents in Europe. 10th Conference on Retroviruses and Opportunistic infections; February 2003; Boston. (Abstract 774)"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000178930.93033.f2"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-1812"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200009290-00008"},{"issue":"2","key":"e_1_2_11_24_1","first-page":"19","article-title":"A syndrome of lipodystrophy (LD), lactic acidemia and liver dysfunction associated with HIV nucleoside analogue reverse transcriptase inhibitor therapy: a contribution to PI\u2010related LD syndrome","volume":"4","author":"Carr A","year":"1999","journal-title":"Antiviral Ther"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200212060-00010"},{"issue":"31","key":"e_1_2_11_26_1","article-title":"Discontinuation of standard first\u2010line antiretroviral therapy in a cohort of 1434 Malawian children","volume":"13","author":"Buck WC","year":"2010","journal-title":"Journal of the International AIDS Society"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.14310\/horm.2002.1305"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.7448\/IAS.15.2.17427","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T14:05:33Z","timestamp":1696169133000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.7448\/IAS.15.2.17427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,4]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012,4]]}},"alternative-id":["10.7448\/IAS.15.2.17427"],"URL":"https:\/\/doi.org\/10.7448\/ias.15.2.17427","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,4]]},"assertion":[{"value":"2011-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-05-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-07-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"17427"}}