Presented at the Conference on Retroviruses and Opportunistic Infections, Montreal, Canada, 2009.
Metabolic abnormalities and viral replication are associated with biomarkers of vascular dysfunction in HIV-infected children
Article first published online: 4 DEC 2011
© 2011 British HIV Association
Volume 13, Issue 5, pages 264–275, May 2012
How to Cite
Miller, T., Borkowsky, W., DiMeglio, L., Dooley, L., Geffner, M., Hazra, R., McFarland, E., Mendez, A., Patel, K., Siberry, G., Van Dyke, R., Worrell, C., Jacobson, D. and Pediatric HIV/AIDS Cohort Study (PHACS) (2012), Metabolic abnormalities and viral replication are associated with biomarkers of vascular dysfunction in HIV-infected children. HIV Medicine, 13: 264–275. doi: 10.1111/j.1468-1293.2011.00970.x
- Issue published online: 1 APR 2012
- Article first published online: 4 DEC 2011
- Manuscript Accepted: 13 SEP 2011
- Eunice Kennedy Shriver National Institute of Child Health and Human Development. Grant Numbers: U01 HD052102-04, U01 HD052104-01
- National Institute of Allergy and Infectious Diseases
- National Institute on Drug Abuse
- National Institute of Mental Health
- National Institute of Deafness and Other Communication Disorders
- National Heart Lung and Blood Institute
- National Institute of Neurological Disorders and Stroke
- National Institute on Alcohol Abuse and Alcoholism
- NIH. Grant Number: UL1 RR025780
- vascular dysfunction;
- cardiovascular risk factors;
HIV-infected children may be at risk for premature cardiovascular disease. We compared levels of biomarkers of vascular dysfunction in HIV-infected children (with and without hyperlipidaemia) with those in HIV-exposed, uninfected (HEU) children enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS), and determined factors associated with these biomarkers.
A prospective cohort study was carried out. Biomarkers of inflammation [C-reactive protein (CRP), interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP1)], coagulant dysfunction (fibrinogen and P-selectin), endothelial dysfunction [soluble intracellular cell adhesion molecule-1 (sICAM), soluble vascular cell adhesion molecule-1 (sVCAM) and E-selectin], and metabolic dysfunction (adiponectin) were measured in 226 HIV-infected and 140 HEU children. Anthropometry, body composition, lipids, glucose, insulin, HIV disease severity, and antiretroviral therapy were recorded.
The median ages of the children were 12.3 years in the HIV-infected group and 10.1 years in the HEU group. Body mass index (BMI) z-scores, waist and hip circumferences, and percentage body fat were lower in the HIV-infected children. Total and non-high-density lipoprotein (HDL) cholesterol and triglycerides were higher in HIV-infected children. HIV-infected children also had higher MCP-1, fibrinogen, sICAM and sVCAM levels. In multivariable analyses in the HIV-infected children alone, BMIz-score was associated with higher CRP and fibrinogen, but lower MCP-1 and sVCAM. Unfavourable lipid profiles were positively associated with IL-6, MCP-1, fibrinogen, and P- and E-selectin, whereas increased HIV viral load was associated with markers of inflammation (MCP-1 and CRP) and endothelial dysfunction (sICAM and sVCAM).
HIV-infected children have higher levels of biomarkers of vascular dysfunction than do HEU children. Risk factors associated with higher biomarkers include unfavourable lipid levels and active HIV replication.