Arterial stiffness and endothelial dysfunction in HIV-infected children.
BACKGROUND
The role of antiretroviral therapy in acceleration of atherosclerosis in HIV-infected adults is controversial, partly because of the confounding effects of the involvement of classic cardiovascular risk factors.


OBJECTIVE
To study vascular function in HIV-infected children.


METHODS
Cross-sectional study of 49 HIV-infected children (34 receiving antiretroviral therapy and 15 never treated) and if 24 age- and sex-matched controls.


METHODS
Automatic, computerized, ultrasonic procedure evaluation of geometric and mechanical properties of the common carotid artery, and of the endothelium-dependent dilation and endothelium-independent dilation.


RESULTS
Relative systolodiastolic variations in diameter of the carotid artery in HIV-infected children were significantly lower than those in controls, but there was no significant difference in intima-media thickness. Cross-sectional compliance and distensibility were also significantly lower. Wall stiffness, assessed as the incremental elastic modulus, was larger in HIV-infected children. Endothelium-dependent dilation was lower in HIV-infected children but non-endothelium-dependent dilation was similar to that in controls. We did not find differences for any of the vascular variables between HIV-infected children receiving antiretroviral therapy and those never treated. All arterial variables were similar in children with and without dyslipidemia.


CONCLUSIONS
HIV-infected children had a vascular dysfunction in the absence of cardiovascular risk factors. In this short series, no additional detrimental effects were observed after a mean of 5 years of antiretroviral therapy.
Bonnet
Damien
D
Department of Pediatrics, Hôpital Necker-Enfants Malades, AP-HP, and INSERM EMI 0016, Faculté de Médecine Necker-Enfants Malades, Paris, France.
Aggoun
Yacine
Y
Szezepanski
Isabelle
I
Bellal
Nassima
N
Blanche
Stéphane
S
D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D019380:Anti-HIV Agents / Q000494:pharmacology; D001916:Brachial Artery / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D014463:Ultrasonography; D014655:Vascular Resistance / Q000187:drug effects; D014664:Vasodilation
D019380:Anti-HIV Agents