XIX International AIDS Conference


MOAB02 Complications of HIV and its Therapy in Children
  Oral Abstract Session : Track B
Venue: Session Room 9
Time: 23.07.2012, 11:00 - 12:30
Co-Chairs: Mark Cotton, South Africa
Jorge Pinto, Brazil
 
 

11:00
MOAB0201
Abstract
Powerpoint
Webcast
Lipid profile in children randomized to immediate versus deferred nevirapine-based antiretroviral therapy in the PREDICT study
S. Kanjanavanit1, T. Puthanakit2,3, P. Kosalaraksa4, R. Hansudewechakul5, C. Ngampiyaskul6, S. Pinyakorn2, W. Luesomboon7, S. Vonthanak8, J. Ananworanich2,9,10, K. Ruxrungtham2,10, PREDICT study group
1Nakornping Hospital, Chiang Mai, Thailand, 2HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center, Bangkok, Thailand, 3Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, 4Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, 5Chiangrai Prachanukroh Hospital, Chiangrai, Thailand, 6Prapokklao Hospital, Chantaburi, Thailand, 7Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand, 8National Center for HIV/AIDS, Dermatology and STDs, Phnom Penh, Cambodia, 9SEARCH, Thai Red Cross AIDS Research Center, Bangkok, Thailand, 10Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
S. Kanjanavanit, Thailand

11:15
MOAB0202
Abstract
Powerpoint
Webcast
Lipoprotein lipase genetic variant P- was associated with lower risk of hypertriglyceridemia in children after one year of HAART
C. Colombero1, C. Rocco1, D. Mecikovsky2, R. Bologna2, P. Aulicino3, L. Sen3, A. Mangano3
1Hospital de Pediatría JP Garrahan, Lab. Biología Celular y Retrovirus, Ciudad de Buenos Aires, Argentina, 2Hospital de Pediatría JP Garrahan, Servicio de Infectología, Ciudad de Buenos Aires, Argentina, 3Hospital de Pediatría JP Garrahan, Lab. Biología Celular y Retrovirus, CONICET, Ciudad de Buenos Aires, Argentina
A. Mangano, Argentina

11:30
MOAB0203
Abstract
Powerpoint
Webcast
Mitochondrial function and metabolic abnormalities in children with perinatally-aquired HIV infection in the Pediatric HIV/AIDS Cohort Study (PHACS)
T.L. Miller1, J. Wang2, D.L. Jacobson2, J.K. Takemoto3, T. Sharma4, M.E. Geffner5, D.E. Libutti3, S. Siminski6, L. Dooley6, G. Somarriba1, P. Graham1, M. Gerschenson7
1University of Miami, Pediatrics, Miami, United States, 2Harvard School of Public Health, Boston, United States, 3University of Hawaii Manoa, Honolulu, United States, 4Children's Hospital Boston, Boston, United States, 5Children's Hospital Los Angeles, Los Angeles, United States, 6Frontier Science & Technology Research Foundation, Inc., Amherst, United States, 7University of Hawaii Manoa, Cellular and Molecular Biology, Honolulu, United States
M. Gerschenson, United States

11:45
MOAB0204
Abstract
Powerpoint
Webcast
Cognitive, neurological and adaptive behaviour functioning among children with perinatally-acquired HIV infection in India
A. Shet1, S. Holla1, V. Raman2, C. Dinakar1, M. Ashok2
1St Johns National Academy of Health Sciences, Paediatrics, Bangalore, India, 2St Johns National Academy of Health Sciences, Psychiatry, Bangalore, India
A. Shet, India

12:00
MOAB0205
Abstract
Clinical screening shows high prevalence of peripheral neuropathy in children taking antiretroviral therapy in rural South Africa
M. van Ramshorst1, H. Struthers2, J.A. McIntyre2,3, R.P.H. Peters1
1Anova Health Institute, Khutso Kurhula Project, Tzaneen, South Africa, 2Anova Health Institute, Johannesburg, South Africa, 3University of Cape Town, School of Public Health, Cape Town, South Africa
R. Peters, South Africa

Powerpoints presentations
Lipid profile in children randomized to immediate versus deferred nevirapine-based antiretroviral therapy in the PREDICT study - Suparat Kanjanavanit

Lipoprotein lipase genetic variant P- was associated with lower risk of hypertriglyceridemia in children after one year of HAART - Andrea Mangano

Mitochondrial function and metabolic abnormalities in children with perinatally-aquired HIV infection in the Pediatric HIV/AIDS Cohort Study (PHACS) - Mariana Gerschenson

Cognitive, neurological and adaptive behaviour functioning among children with perinatally-acquired HIV infection in India - Anita Shet



Rapporteur report

Track B report by Dr. John McKinnon


1. Lipid profile in children randomized to immediate versus deferred nevirapine-based antiretroviral therapy in the PREDICT study, by Suparat Kanjanavanit
Conclusion low levels of dyslipidemia with immediate ART treatment. Action: Initiation of ART in children did impact on dyslipidemia and should not withhold therapy due to preexisting lipid abnormalities. Summary: Initiation of first line ART early did not have a negative impact on dyslipidemia as compared to deferred ART.

2. Lipoprotein lipase genetic variant P- was associated with lower risk of hypertriglyceridemia in children after one year of HAART, by A. Mangano
Concluison: Protective LPL H-, P- haplotypes reduced the risk of elevated TG after 1 year of ART. Discussion: The polymorphisms did not impact baseline TG levels. Even heterozygous P-/P+ population had some benefit in TG levels. Action: Evaluation of LPL haplotypes may help to predict who will be more likely to have hypertriglyceridemia. Summary: Protective LPL haplotypes H- and P- reduce the risk of elevated TG levels following 1 year of ART.

3. Mitochondrial function and metabolic abnormalities in children with perinatally-acquired HIV infection in the Pediatric HIV/AIDS Cohort Study, by Mariana Gerschenson
Conclusion: Insulin resistance associated with higher venous Lactate and pyruvate. Higher TG associated with higher venous lactate. Action: Monitoring of venous lactate and pyruvate levels may aid in early determination of metabolic abnormalities. Summary: Mitochondrial dysfunction is involved in the systemic metabolic abnormalities including insulin resistance, higher venous lactate and pyruvate, and lipid abnormalities.

4. Cognitive, neurological and adaptive behavior functioning among children with perinatally-acquired HIV infection in India, by Anita Shet
Conclusion: HIV+ children are at higher risk for soft neurologic difficulties, lower IQ scores, which were worsened by malnutrition and anemia. ART had a positive effect in improving these risk and IQ scores. Action: Early ART therapy has a positive effect on lower the risk of soft neurologic and low IQ scores and improved nutrition should also have a positive impact on HIV+ children development. Summary: HIV+ children have more soft neurologic, and cognitive deficiencies than HIV- negative children, and this is improved by ART therapy. Impact of malnutrition was noted and improved nutritional status should aid in their development.

5. Clinical screening shows high prevalence of peripheral neuropathy in children taking antiretroviral therapy in rural South Africa, by Renco P.H. Peters
Conclusion: Peripheral neuropathy was common in HIV+ children in this rural area and NSS and NDS tools were able to identify neurologic symptoms. Additionally, the children can provide better history relating neurologic dysfunction. Action: Increase monitoring for neurologic dysfunction should be done and movement away from D4T based regimens should improve this symptoms. Summary: High prevalence of peripheral neuropathy based on NSS and NDS tools in rural children in South Africa.

Session summary
HIV+ children are at higher risk of metabolic abnormalities, mitochondrial dysfunction and, neurocognitive deficits and peripheral neuropathy than HIV negative children. Early ART may improve neurocognitive deficits but may impact metabolic and peripheral neuropathy. Nutrition may provide benefits in all these areas.

Discussion
Key topic was the impact of better nutrition and ART therapy on overall improvement of these metabolic and neurologic/cognitive deficits.


   

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