Document Detail


Longitudinal changes in carotid intima-media thickness and cardiovascular risk factors in human immunodeficiency virus-infected children and young adults compared with healthy controls.
MedLine Citation:
PMID:  20589981     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: HIV-infected patients are at increased risk of cardiovascular disease (CVD). This study assessed longitudinal changes in carotid intima-media thickness (cIMT) as a surrogate marker for CVD, and determined the relationship between cIMT and cardiovascular risk factors in HIV infected children/young adults. METHODS: This was a longitudinal, observational study comparing cIMT,fasting metabolic profile, and C-reactive protein in HIV-infected subjects 2 to 21 years old to matched controls at baseline and 48 weeks. RESULTS: Thirty-five HIV + subjects and 37 controls were included in the analysis. Among HIV + subjects, the median age was 10 years, body mass index was 18.7 kg/m2, 37% were male, CD4 count was 32%, 77% had HIV-RNA 400 copies/mL, and 86% were on antiretrovirals. At baseline,HIV + had higher lipids and C-reactive protein. HIV-infected had higher internal carotid artery (ICA) and common carotid artery (CCA) IMT (mm)(ICA: HIV + , 0.90; controls, 0.78 [P = 0.01]; CCA: HIV + , 1.00; controls,0.95 [P = 0.05]). At 48 weeks, CD4% increased and low-density lipoprotein decreased in HIV-infected subjects. ICA and CCA median changes for HIV-infected subjects were -0.23 and -0.15 mm, respectively (both P 0.01). In controls, only CCA changed (P = 0.04). Between-group changes were not significant, except when only 31 perinatally infected HIV - subjects and the controls were compared (CCA P = 0.04). In multiple regression analyses of HIV + subjects, antiretroviral therapy duration and CD4% were associated with cIMT changes. CONCLUSIONS: Higher cIMT was found in HIV-infected subjects than in healthy controls, but at 48 weeks, cIMT was similar between groups. These data suggest that HIV-infected children/young adults are at high risk of CVD, but lipid control, immune restoration, and viral suppression with continuous antiretroviral therapy may prevent its worsening.
Authors:
Allison C Ross; Norma Storer; Mary Ann O'Riordan; Vikram Dogra; Grace A McComsey
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  29     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-28     Completed Date:  2010-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  634-8     Citation Subset:  IM    
Affiliation:
Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30322, USA. across3@emory.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
C-Reactive Protein / analysis
CD4 Lymphocyte Count
Cardiovascular Diseases / epidemiology*,  pathology
Carotid Artery Diseases / epidemiology*,  pathology
Case-Control Studies
Child
Child, Preschool
Female
HIV Infections / complications*
Humans
Longitudinal Studies
Male
Metabolome
Risk Factors
Tunica Intima / pathology*
Tunica Media / pathology*
Viral Load
Young Adult
Chemical
Reg. No./Substance:
9007-41-4/C-Reactive Protein

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


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