BACKGROUND: Recent evidence suggests that both the HIV virus and antiretroviral therapy (ART) are associated with premature atherosclerosis in adults. Increased arterial stiffness as assessed by pulse wave velocity (PWV) has been associated with adverse cardiovascular outcome in adults. The relationship between HIV infection and treatment and arterial stiffness has not been evaluated in children. METHODS: We studied 83 HIV-infected children with a mean +/-sd age of 11.0 +/-3.1 years and 59 controls aged 12.2 +/-2.8 years. Among the HIV-infected children, 48 were receiving ART (23 including a protease inhibitor). Arterial stiffness was assessed non-invasively by carotid-radial PWV. Disease severity was defined according to the CDC classification. RESULTS: PWV was significantly increased in HIV-infected children compared with controls (P<0.05). A significant association between age and PWV was noted in HIV-infected children but not in controls. HIV-infected children receiving ART had significantly increased total cholesterol levels and PWV compared with non-treated children (P<0.001 and P<0.05, respectively). CDC stage was greater in ART-treated compared with non-treated HIV-infected children (P<0.001). No differences in other cardiovascular risk factors were noted in the two groups. After multivariable analysis, ART, systolic blood pressure, disease severity and total cholesterol remained independent predictors of PWV. CONCLUSIONS: HIV-infected children have increased arterial stiffness compared with healthy children. These changes were more pronounced with increasing age in HIV-infected children particularly in those who were receiving ART.
BACKGROUND: Recent evidence suggests that both the HIV virus and antiretroviral therapy (ART) are associated with premature atherosclerosis in adults. Increased arterial stiffness as assessed by pulse wave velocity (PWV) has been associated with adverse cardiovascular outcome in adults. The relationship between HIV infection and treatment and arterial stiffness has not been evaluated in children. METHODS: We studied 83 HIV-infectedchildren with a mean +/-sd age of 11.0 +/-3.1 years and 59 controls aged 12.2 +/-2.8 years. Among the HIV-infectedchildren, 48 were receiving ART (23 including a protease inhibitor). Arterial stiffness was assessed non-invasively by carotid-radial PWV. Disease severity was defined according to the CDC classification. RESULTS: PWV was significantly increased in HIV-infectedchildren compared with controls (P<0.05). A significant association between age and PWV was noted in HIV-infectedchildren but not in controls. HIV-infectedchildren receiving ART had significantly increased total cholesterol levels and PWV compared with non-treated children (P<0.001 and P<0.05, respectively). CDC stage was greater in ART-treated compared with non-treated HIV-infectedchildren (P<0.001). No differences in other cardiovascular risk factors were noted in the two groups. After multivariable analysis, ART, systolic blood pressure, disease severity and total cholesterol remained independent predictors of PWV. CONCLUSIONS:HIV-infectedchildren have increased arterial stiffness compared with healthy children. These changes were more pronounced with increasing age in HIV-infectedchildren particularly in those who were receiving ART.
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Authors: T I Miller; W Borkowsky; L A DiMeglio; L Dooley; M E Geffner; R Hazra; E J McFarland; A J Mendez; K Patel; G K Siberry; R B Van Dyke; C J Worrell; D L Jacobson; William Shearer; Norma Cooper; Lynette Harris; Murli Purswani; Mahboobullah Baig; Anna Cintron; Ana Puga; Sandra Navarro; Doyle Patton; Sandra Burchett; Nancy Karthas; Betsy Kammerer; Ram Yogev; Kathleen Malee; Scott Hunter; Eric Cagwin; Andrew Wiznia; Marlene Burey; Molly Nozyce; Janet Chen; Elizabeth Gobs; Mitzie Grant; Katherine Knapp; Kim Allison; Patricia Garvie; Midnela Acevedo-Flores; Heida Rios; Vivian Olivera; Margarita Silio; Cheryl Borne; Patricia Sirois; Stephen Spector; Kim Norris; Sharon Nichols; Elizabeth McFarland; Emily Barr; Carrie Chambers; Douglas Watson; Nicole Messenger; Rose Belanger; Arry Dieudonne; Linda Bettica; Susan Adubato; Gwendolyn Scott; Lisa Himic; Elizabeth Willen Journal: HIV Med Date: 2011-12-04 Impact factor: 3.180
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