Document Detail


Lipid changes in Kenyan HIV-1-infected infants initiating highly active antiretroviral therapy by 1 year of age.
MedLine Citation:
PMID:  23385950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Early highly active antiretroviral therapy (HAART) is recommended for HIV-1-infected infants. There are limited data on lipid changes during infant HAART.
METHODS: Nonfasting total (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol and triglycerides (TG) were measured at 0, 6 and 12 months. Correlates of lipid levels and changes post-HAART were assessed using linear regression.
RESULTS: Among 115 infants, pre-HAART median age was 3.8 months, CD4% was 19% and weight-for-age Z score was -2.42. Pre-HAART median lipid levels were: TC, 108.7 mg/dL; LDL, 42.5 mg/dL; HDL, 29.4 mg/dL and TG, 186.9 mg/dL. Few infants had abnormally high TC (6.2%) or LDL (5.6%), but many had low HDL (76.5%) or high TG (69.6%). Higher pre-HAART weight-for-age and height-for-age Z scores were each associated with higher pre-HAART TC (P = 0.04 and P = 0.01) and LDL (P = 0.02 and P = 0.008). From 0 to 6 months post-HAART, TC (P < 0.0001), LDL (P < 0.0001) and HDL (P < 0.0001) increased significantly, and 23.1% (P = 0.002), 14.0% (P = 0.2), 31.3% (P < 0.0001) and 50.8% (P = 0.2) of infants had abnormally high TC, high LDL, low HDL and high TG, respectively. Changes in TC and HDL were each associated with higher gain in weight-for-age Z score (P = 0.03 and P = 0.01) and height-for-age Z score (P = 0.01 and P = 0.007). Increased change in LDL was associated with higher gain in height-for-age Z score (P = 0.03). Infants on protease inhibitor-HAART had smaller HDL increase (P = 0.004).
CONCLUSIONS: Infants had substantive increases in lipids, which correlated with growth. Increases in HDL were attenuated by protease inhibitor-HAART. It is important to determine clinical implications of these changes.
Authors:
Agnes Langat; Sarah Benki-Nugent; Dalton Wamalwa; Ken Tapia; Evelyn Ngugi; Lara Diener; Barbra A Richardson; Ann Melvin; Grace C John-Stewart
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  32     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-11     Completed Date:  2014-02-06     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e298-304     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Anti-Retroviral Agents / administration & dosage*
Antiretroviral Therapy, Highly Active / methods*
Female
Follow-Up Studies
HIV Infections / drug therapy*,  virology
HIV-1 / isolation & purification
Humans
Infant
Kenya
Lipids / blood*
Male
Grant Support
ID/Acronym/Agency:
# D43 TW000007/TW/FIC NIH HHS; 2 R01 HD023412/HD/NICHD NIH HHS; D43 TW000007/TW/FIC NIH HHS; K01 NS080637/NS/NINDS NIH HHS; K24 HD054314/HD/NICHD NIH HHS; K24 HD054314/HD/NICHD NIH HHS; P30 AI027757/AI/NIAID NIH HHS; P30 AI027757/AI/NIAID NIH HHS; R01 HD023412/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Retroviral Agents; 0/Lipids
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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