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.
BACKGROUND: Early highly active antiretroviral therapy (HAART) is recommended for HIV-1-infectedinfants. 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: Rohan Hazra; Rachel A Cohen; René Gonin; Jacqueline P Monteiro; Cristina B Hofer; Marinella D Negra; Noris P Ruz Journal: AIDS Date: 2012-01-14 Impact factor: 4.177
Authors: Avy Violari; Jane C Lindsey; Michael D Hughes; Hilda A Mujuru; Linda Barlow-Mosha; Portia Kamthunzi; Benjamin H Chi; Mark F Cotton; Harry Moultrie; Sandhya Khadse; Werner Schimana; Raziya Bobat; Lynette Purdue; Susan H Eshleman; Elaine J Abrams; Linda Millar; Elizabeth Petzold; Lynne M Mofenson; Patrick Jean-Philippe; Paul Palumbo Journal: N Engl J Med Date: 2012-06-21 Impact factor: 91.245
Authors: Dalton Wamalwa; Sarah Benki-Nugent; Agnes Langat; Ken Tapia; Evelyn Ngugi; Jennifer A Slyker; Barbra A Richardson; Grace C John-Stewart Journal: Pediatr Infect Dis J Date: 2012-07 Impact factor: 2.129
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: Avy Violari; Mark F Cotton; Diana M Gibb; Abdel G Babiker; Jan Steyn; Shabir A Madhi; Patrick Jean-Philippe; James A McIntyre Journal: N Engl J Med Date: 2008-11-20 Impact factor: 91.245