Sahera Dirajlal-Fargo1,2,3,4, Grace A McComsey5,6,7. 1. Rainbow Babies and Children's Hospital, Cleveland, OH, USA. Sahera.dirajlal-fargo@uhhospitals.org. 2. University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA. Sahera.dirajlal-fargo@uhhospitals.org. 3. Case Western Reserve University, Cleveland, OH, USA. Sahera.dirajlal-fargo@uhhospitals.org. 4. University Hospitals Cleveland Medical Center, Case School of Medicine, Cleveland, OH, 44106, USA. Sahera.dirajlal-fargo@uhhospitals.org. 5. Rainbow Babies and Children's Hospital, Cleveland, OH, USA. 6. University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA. 7. Case Western Reserve University, Cleveland, OH, USA.
Abstract
PURPOSE OF REVIEW: Antiretroviral therapy (ART) scale-up has dramatically reduced rates of pediatric HIV mortality and morbidity. Children living with perinatally acquired HIV (PHIV) are now expected to live through adolescence and well into adulthood, such that adolescents now represent the largest growing population living with HIV. This review aims to discuss the prevalence and mechanisms for cardiometabolic comorbidities in the setting of newer ART regimens and the research gaps that remain. RECENT FINDINGS: Data highlight the continued risks of subclinical cardiometabolic complications in PHIV in the setting of newer ART. Novel techniques in imaging and omics may help identify early cardiometabolic abnormalities in this young population and potentially identify early changes in the mechanistic pathways related to these changes. Further studies to determine risk and management strategies of the cardiometabolic effects in PHIV adolescents, beyond ART, are warranted. Focus should be on prevention of these complications in youth to avoid new epidemic of diabetes and cardiovascular disease when these youths become aging adults.
PURPOSE OF REVIEW: Antiretroviral therapy (ART) scale-up has dramatically reduced rates of pediatric HIV mortality and morbidity. Children living with perinatally acquired HIV (PHIV) are now expected to live through adolescence and well into adulthood, such that adolescents now represent the largest growing population living with HIV. This review aims to discuss the prevalence and mechanisms for cardiometabolic comorbidities in the setting of newer ART regimens and the research gaps that remain. RECENT FINDINGS: Data highlight the continued risks of subclinical cardiometabolic complications in PHIV in the setting of newer ART. Novel techniques in imaging and omics may help identify early cardiometabolic abnormalities in this young population and potentially identify early changes in the mechanistic pathways related to these changes. Further studies to determine risk and management strategies of the cardiometabolic effects in PHIV adolescents, beyond ART, are warranted. Focus should be on prevention of these complications in youth to avoid new epidemic of diabetes and cardiovascular disease when these youths become aging adults.
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