Acompanhamento antropométrico de uma coorte de crianças e adolescentes infectados pelo vírus da imunodeficiência humana atendidos em centro de referência

Abstract

Access to antiretroviral treatment and survival of HIV-infected children and adolescents increased, so it has been necessary to describe the growth and lipid profile alterations in these patients. A cohort study on Belo Horizonte, Minas Gerais. Following vertically HIV-infected children and adolescents at the Pediatrics AIDS Outpatient Center, Federal University of Minas Gerais. This open cohort started in February 1989 and the analyses were carried out using information of HIV infected children and adolescents who started highly active antiretroviral therapy (HAART) from 1998 until 2008. The purpose of this study was to longitudinally assess the growth, triglycerides and cholesterol profile of HIV-infected children and adolescents. Data were analyzed using mixed-effects linear regression models fitted by restricted maximum likelihood. The longitudinal evaluation of growth was carried with one hundred and seventy two HIV infected children and adolescents, whereas the longitudinal evaluation of triglycerides and cholesterol profile, with twentyseven. At the end of the analysis it was observed that: during the period of exposure HAART girls were heavier and taller than the boys; children who were exposure to PI had significant increase in weight-for-age z-score, and were taller than those used NNRTI; those who had viral load 5 log at baseline were weightiness compared with those who started HAART with viral load < 5 log, until one year of exposure; during the period of exposure the children showed significant increase in the z-score weigh-for-age and heightfor- age; increased levels of triglycerides and cholesterol were observed in fifteen (55.5%) and seven (29.2%) at baseline and in eleven (40.7%) and fifteen (62.5%) after median f 41.9 months using HAART; children exposed to NNRTI had decrease on triglycerides and increased of cholesterol levels compared to baseline with longitudinal effect measured monthly with exposure to antiretroviral; children exposed to PI had increment on triglycerides and cholesterol levels; an increment in cholesterol levels of 23.4 mg/dL and 52.5 mg/dL were observed in exposed both to NNRTI and PI, respectively and it was associated to CD4 count. The present work shows the positive effect of the introduction of antiretroviral therapy on growth. The study of lipid profile shows that antiretroviral therapy may be associated with changes in serum triglycerides and cholesterol.