Growth aspects of HIV-infected adolescents in South America

Abstract

HIV infection epidemiology in adolescents is divided into two groups: vertical and sexual transmission. When both groups have access to antiretroviral therapy, and HIV becomes a chronic disease, several nutritional issues are observed and must be better studied in South American population. In HIV vertically infected adolescents, who were exposed to several antiretroviral practices, including antiretroviral regimens of lower potency used in the past, the main problem is related to lower stature when compared to the same-age population, but not necessarily lower weight. As a consequence, a cohort with higher body mass index has been created. Adolescents with HIV who had been sexually infected are probably those who are recently infected, and they reflect the epidemiology of HIV in South America: more prevalent among young and poor females. The study of the nutritional aspects of this population demonstrates a fiber poor, fat rich diet in a population without the right nutritional knowledge with higher tendency to be overweight. In the population that is using antiretrovirals, the frequency of lipodystrophy syndrome, i.e., fat redistribution (mainly lipohypertrophy) and metabolic alterations, such as dyslipidemia, insulin resistance, or lactic acidosis, is higher than in the population without medication, and factors associated with this syndrome and several consequences are discussed in this chapter.