ATN 021B: PREVALENCE OF MORPHOLOGIC AND METABOLIC ABNORMALITIES IN HIV-INFEC

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This study is a cross-sectional survey designed to evaluate the prevalence and severity of alterations in fat distribution, glucose, lipid metabolism, and BMD in HIV-infected and -uninfected male youth as well as drug and non-drug factors related to their presence. Despite unarguable advances in HIV care associated with highly active antiretroviral therapy, it is now apparent that many patients on these regimens are developing potentially deleterious metabolic complications, which include insulin resistance, dyslipidemia, alterations in fat distribution, osteopenia, osteoporosis, and, less commonly, hyperlactatemia. Although the long-term risks associated with these complications in patients with HIV infection are unknown, there is mounting concern that they may impact the long-term prognosis in patients whose life expectancies are significantly extended due to effective viral suppression by HAART. In this study, the prevalence of morphological and metabolic abnormalities in HIV-uninfected youth at high risk for HIV infection and HIV-infected youth on different types of antiretroviral medications will be determined. Approximately 250 male youth between the ages of 12 years, 0 days and 24 years, 364 days will be enrolled in four study groups: a group of 50 HIV-negative subjects; a group of 100 HIV-positive subjects who are antiretroviral therapy nanve; and two groups of up to 50 HIV-positive subjects each, one on an NNRTI-based regimen and the other on a PI-based regimen.