Risk factors for cardiovascular disease in children infected with human immunodeficiency virus-1

J Pediatr. 2008 Oct;153(4):491-7. doi: 10.1016/j.jpeds.2008.04.016. Epub 2008 Jun 9.

Abstract

Objective: To determine risk factors for cardiovascular disease (CVD) in children infected with human immunodeficiency virus (HIV) compared with nationally representative controls from 2003-2004 National Health and Nutrition Examination Survey (NHANES) data.

Study design: A prospective, longitudinal analysis of CVD risk factors in 42 HIV-infected children compared with NHANES controls, with multivariable modeling of demographic, disease-specific, and treatment-related factors contributing to cardiac risk in the HIV cohort.

Results: The 42 children infected with HIV were initially an average of 10.1 years old; 68% were Centers for Disease Control and Prevention pediatric HIV disease stage B or C, and 76% were receiving highly active antiretroviral therapy (HAART). Compared with age- and sex-adjusted NHANES controls, the children infected with HIV had lower weight (-0.46 standard deviation [SD] vs +0.54 SD; P < .001), height (-0.62 SD vs +0.26 SD; P < .001), and body mass index (-0.09 SD vs +0.51 SD; P < .001), a higher level of triglycerides (136 mg/dL vs 90 mg/dL; P < .001), and a lower level of high-density lipoprotein (HDL) cholesterol (47 mg/dL vs 54 mg/dL; P < .001). Protease inhibitor therapy was independently associated with higher triglyceride (P = .02) and low-density lipoprotein cholesterol levels (P = .04) and lower HDL cholesterol level (P = .02); nonnucleoside reverse-transcriptase inhibitor therapy was associated with lower visceral fat (P = .01) and higher HDL cholesterol level (P = .005).

Conclusions: Children infected with HIV have adverse cardiac risk profiles compared with NHANES controls. Antiretroviral therapy has a significant influence on these factors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Abdominal Fat / diagnostic imaging
  • Antiretroviral Therapy, Highly Active
  • Cardiovascular Diseases / epidemiology*
  • Child
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • HIV Infections / blood
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • Humans
  • Multivariate Analysis
  • Nutrition Surveys
  • Prospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed
  • Triglycerides / blood

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides

Grant support