@article{fdi:010073721,
  title = {{L}ow prevalence of lipodystrophy in {HIV}-infected {S}enegalese children on long-term antiretroviral treatment : the {ANRS} 12279 {MAGGSEN} {P}ediatric {C}ohort {S}tudy},
  author = {{C}ames, {C}{\'e}cile and {P}ascal, {L}{\'e}a and {B}a, {A}. and {M}bodj, {H}. and {O}uattara, {B}. and {D}iallo, {N}. {F}. and {M}sellati, {P}hilippe and {M}baye, {N}. and {S}ignate, {H}. {S}. and {B}lanche, {S}. and {D}iack, {A}. and {MAGGSEN} {C}ohort {S}tudy {G}roup},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he long-term benefits of antiretroviral treatment ({ART}) are associated with metabolic complications, especially lipodystrophy, which has been well described among {HIV}-infected adults and children on {ART} in developed settings. {S}pecifically, stavudine, and to a lesser extent zidovudine and protease inhibitors ({PI}), have been consistently implicated in the development of lipodystrophy. {I}n 2006, following advice from the {WHO}, {S}enegal began phasing out stavudine from first-line {ART}. {T}he objectives of this cross-sectional analysis are to assess and identify risk factors affecting the prevalence of lipodystrophy in {S}enegalese children and adolescents on long-term {ART} participating in a cohort study. {M}ethods: {L}ipodystrophy was clinically assessed in two- to 18-year-old children on {ART} for at least six months and with no concurrent severe acute malnutrition. {R}isk factors for lipodystrophy were identified using stepwise multivariable logistic regression. {E}xplanatory variables included clinical and personal data, immunovirologic status, and therapeutic history. {R}esults: {O}verall, 254 children were assessed for lipodystrophy. {T}he median age was 10.9 years ({IQR}: 8.1-142) and the median duration on {ART} was 54 months (32-84). {O}nly 18% had been previously treated with stavudine, with a median treatment duration of 8 months (5-25). {O}ngoing treatment included 76% of children receiving zidovudine (median duration of 48 months (26-74)) and 27% receiving {PI} (lopinavir/ritonavir; median duration of 49 months (23-59)). {M}ild signs of lipodystrophy were observed in 33 children (13%): 28 with lipoatrophy, 4 with lipohypertrophy and one with combined type. {B}oys were more likely to present with lipoatrophy than girls (a{OR}: 4.3, 95% {CI}: 1.6-11.7). {C}hildren previously treated with stavudine for >= 1 year had a greater risk for lipoatrophy than those never exposed (3.8, 1.0-14.0), although the association was weak. {T}here was no association between lipodystrophy and age or current or cumulative treatment with lopinavir/ritonavir or zidovudine. {C}onclusions: {W}e report low prevalence of mild lipodystrophy in children and adolescents on long-term {ART} receiving a stavudine-sparing regimen. {T}hese findings are reassuring for clinicians in low-income settings where zidovudine is massively prescribed and lopinavir/ritonavir is the only widely available {PI}.},
  keywords = {{L}ipodystrophy ; {L}ipoatrophy ; {C}hildren ; {A}dolescents ; {HIV}-infection ; {ART} ; {S}tavudine ; {Z}idovudine ; {P}rotease inhibitor ; {SENEGAL}},
  booktitle = {},
  journal = {{BMC} {I}nfectious {D}iseases},
  volume = {18},
  numero = {},
  pages = {art. 374 [9 p.]},
  ISSN = {1471-2334},
  year = {2018},
  DOI = {10.1186/s12879-018-3282-7},
  URL = {https://www.documentation.ird.fr/hor/fdi:010073721},
}