Dirajlal-Fargo, S;
Musiime, V;
Cook, A;
Mirembe, G;
Kenny, J;
Jiang, Y;
Debanne, S;
... McComsey, GA; + view all
(2017)
Insulin Resistance and Markers of Inflammation in HIV-Infected Ugandan Children in the CHAPAS 3 Trial.
Pediatric Infectious Disease Journal
, 36
(8)
pp. 761-767.
10.1097/INF.0000000000001544.
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Abstract
BACKGROUND: Few studies have investigated metabolic complications in HIV-infected African children and their relation with inflammation. METHODS:: We compared baseline and changes in insulin resistance (HOMA-IR) and in markers of inflammation over 48 weeks, in a subset of antiretroviral therapy (ART) naïve Ugandan children from the CHAPAS-3 trial randomized to zidovudine (AZT), stavudine (D4T) or abacavir (ABC) based regimens. Non-parametric methods were used to explore between and within group differences and multivariable analyses to assess associations of HOMA-IR. RESULTS:: 118 children were enrolled; median age (IQR) was 2.8 years (1.7-4.3). Baseline median HOMA-IR (IQR) was 0.49 (0.38, 1.07) and similar between the arms. At week 48, median relative changes in HOMA-IR were 14% (-29%, 97%) in the AZT arm, -1% (-30%, 69%) in the D4T arm, and 6% (-34%, 124%) in the ABC arm (p≤0.03 for all arms compared to baseline, but p=0.90 for between-group differences). Several inflammation markers significantly decreased in all study arms; sCD14 increased on ABC and did not change in the other two arms. In multivariate analysis, only changes in sCD163 were positively associated with HOMA-IR changes. CONCLUSIONS:: In ART naïve Ugandan children, HOMA-IR changed significantly after 48 weeks of ART and correlated with monocyte activation.
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