PubMed · 12184299
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OBJECTIVE: To assess body composition changes in HIV-infected children receiving highly active antiretroviral therapy (HAART). METHODS: Thirty-seven HIV-positive children were enrolled. Dual-energy X-ray absorptiometry (DXA) scans were performed in all HIV-infected children at baseline and after an additional 12 months of HAART and in 54 matched (for sex, age, body mass index [BMI], and pubertal stage) healthy controls. Abdominal MRI was performed in 14 of 37 HIV-positive children at baseline and in 28 of 37 HIV-positive children after additional 12 months of HAART. RESULTS: During the study period, mean HAART exposure increased from 39.3 to 50.9 months and the number of HIV-infected children with clinical lipodystrophy (LD) increased from 6 to 8, whereas mean BMI, CD4 percentage, and percentage of HIV-infected children with HIV RNA <50 copies/mL did not change. DXA scans showed an increase in lean mass, peripheral fat loss, and central fat accumulation in all HIV-infected children. As compared with controls, 70% and 84% of HIV-infected children showed DXA-detectable LD at baseline and at 12 months of follow-up, respectively. Mixed LD and central fat accumulation were the most common LD phenotype. At baseline and at 12 months of follow-up, intra-abdominal adipose tissue (IAT) was greater than in controls in 33% and 35% of HIV-infected children, and it was greater in those with LD than in those without. Peripheral fat loss and IAT content were associated with duration of HAART and were independent of immunologic stage of disease and immunologic response. CONCLUSIONS: Changes in body composition related to LD in HAART-treated children are frequent, precocious, and progressive. Duration of HAART negatively influences visceral adiposity and peripheral fat loss.
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BACKGROUND AND AIMS: To ascertain whether the absorption of L-lysine diatrizoate, a sodium-free salt of the contrast-giving diatrizoic acid from the gastrointestinal tract is increased by surgery, inflammation, and neoplasia. PATIENTS AND METHODS: The prospective study comprised 32 patients who were undergoing radiological examination of the upper gastrointestinal tract with a contrast medium containing L-lysine diatrizoate and 52 further patients who were undergoing examination of the lower gastrointestinal tract in the same way. The concentration of diatrizoic acid was determined by high-pressure liquid chromatography in blood samples taken before and immediately after the radiological examinations. The results were examined in terms of sex, age, surgical history, and any evidence of inflammatory or neoplastic diseases. RESULTS: The serum diatrizoic acid concentration in patients tested after oral administration was 3.62 microg/ml. In patients who had undergone operation the titer was lower than in those who had not been operated on. Serum diatrizoic acid concentration in patients tested after rectal administration was 0.30 microg/ml. In patients suffering from inflammatory conditions or neoplasms the titer was significantly higher than in the other patients. CONCLUSION: The L-lysine salt of diatrizoic acid is absorbed in larger amounts from the upper gastrointestinal tract than from the lower. Absorption is not increased after surgical operations on the viscera. However, inflammatory conditions and neoplasms involving the large bowel increase the uptake of the contrast medium from the intestine.