Dyslipidemia among perinatally HIV-infected children enrolled in the PACTS-HOPE cohort, 1999-2004: a longitudinal analysis.
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.
Carter
Rosalind J
RJ
Medical and Health Research Association, New York, NY 10032, USA. rc2315@columbia.edu
Wiener
Jeffrey
J
Abrams
Elaine J
EJ
Farley
John
J
Nesheim
Steven
S
Palumbo
Paul
P
Bulterys
Marc
M
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D006937:Hypercholesterolemia / Q000139:chemically induced*; D015228:Hypertriglyceridemia / Q000139:chemically induced*; D007223:Infant; D008060:Lipodystrophy / Q000139:chemically induced; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D013223:Statistics as Topic; D014280:Triglycerides / Q000097:blood; D019562:Viral Load
D017320:HIV Protease Inhibitors; D014280:Triglycerides; D002784:Cholesterol