| Longitudinal changes in carotid intima-media thickness and cardiovascular risk factors in human immunodeficiency virus-infected children and young adults compared with healthy controls. | |
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MedLine Citation:
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PMID: 20589981 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Allison C Ross; Norma Storer; Mary Ann O'Riordan; Vikram Dogra; Grace A McComsey |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Pediatric infectious disease journal Volume: 29 ISSN: 1532-0987 ISO Abbreviation: Pediatr. Infect. Dis. J. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-28 Completed Date: 2010-09-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8701858 Medline TA: Pediatr Infect Dis J Country: United States |
Other Details:
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Languages: eng Pagination: 634-8 Citation Subset: IM |
Affiliation:
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Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30322, USA. across3@emory.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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