BACKGROUND: Protease inhibitor (PI)-containing regimens have led to improved survival among HIV-infected children. However, adverse effects, including dyslipidemia, may put children at risk for cardiovascular disease. METHODS: Serum cholesterol and triglyceride levels were recorded on perinatally HIV-infected children participating in the PACTS-HOPE cohort (1999-2004). Hypercholesterolemia (HC) was defined as cholesterol > or =200 mg/dL and hypertriglyceridemia (HT) as triglycerides >or =150 mg/dL. HC and HT were modeled over time using generalized estimating equations. RESULTS: For 178 children, 47% met criteria for HC and 67% for HT at least once during the study period. In generalized estimating equation models, PI use, undetectable viral load, and immunologic category 3 were independent predictors of HC. HT was significantly associated with PI use and body mass index (BMI) > or =90th percentile for age and gender. Among children on PI-containing regimens, HC was significantly associated with multiple PIs and undetectable viral load; HT was predicted by body mass index > or =90th percentile and ritonavir use. The prevalence of clinical lipodystrophy was 5.6% (10/178). CONCLUSIONS: Children on PI-containing regimens have a higher risk of both HC and HT. Lipid levels should be measured regularly in children on antiretroviral treatment. Interventions such as diet, exercise, or lipid-lowering drug therapy may benefit some children.
BACKGROUND:Protease inhibitor (PI)-containing regimens have led to improved survival among HIV-infectedchildren. However, adverse effects, including dyslipidemia, may put children at risk for cardiovascular disease. METHODS: Serum cholesterol and triglyceride levels were recorded on perinatally HIV-infectedchildren participating in the PACTS-HOPE cohort (1999-2004). Hypercholesterolemia (HC) was defined as cholesterol > or =200 mg/dL and hypertriglyceridemia (HT) as triglycerides >or =150 mg/dL. HC and HT were modeled over time using generalized estimating equations. RESULTS: For 178 children, 47% met criteria for HC and 67% for HT at least once during the study period. In generalized estimating equation models, PI use, undetectable viral load, and immunologic category 3 were independent predictors of HC. HT was significantly associated with PI use and body mass index (BMI) > or =90th percentile for age and gender. Among children on PI-containing regimens, HC was significantly associated with multiple PIs and undetectable viral load; HT was predicted by body mass index > or =90th percentile and ritonavir use. The prevalence of clinical lipodystrophy was 5.6% (10/178). CONCLUSIONS:Children on PI-containing regimens have a higher risk of both HC and HT. Lipid levels should be measured regularly in children on antiretroviral treatment. Interventions such as diet, exercise, or lipid-lowering drug therapy may benefit some children.
Authors: Denise L Jacobson; Kunjal Patel; George K Siberry; Russell B Van Dyke; Linda A DiMeglio; Mitchell E Geffner; Janet S Chen; Elizabeth J McFarland; William Borkowsky; Margarita Silio; Roger A Fielding; Suzanne Siminski; Tracie L Miller Journal: Am J Clin Nutr Date: 2011-11-02 Impact factor: 7.045
Authors: Katherine Tassiopoulos; Paige L Williams; George R Seage; Marilyn Crain; James Oleske; John Farley Journal: J Acquir Immune Defic Syndr Date: 2008-04-15 Impact factor: 3.731
Authors: Grace M Aldrovandi; Jane C Lindsey; Denise L Jacobson; Amanda Zadzilka; Elizabeth Sheeran; Jack Moye; Peggy Borum; William A Meyer; Dana S Hardin; Kathleen Mulligan Journal: AIDS Date: 2009-03-27 Impact factor: 4.177
Authors: Kunjal Patel; Jiajia Wang; Denise L Jacobson; Steven E Lipshultz; David C Landy; Mitchell E Geffner; Linda A Dimeglio; George R Seage; Paige L Williams; Russell B Van Dyke; George K Siberry; William T Shearer; Luciana Young; Gwendolyn B Scott; James D Wilkinson; Stacy D Fisher; Thomas J Starc; Tracie L Miller Journal: Circulation Date: 2013-12-23 Impact factor: 29.690