Risk factors for cardiovascular disease in children infected with human immunodeficiency virus-1.
OBJECTIVE
To determine risk factors for cardiovascular disease (CVD) in children infected with human immunodeficiency virus (HIV) compared with nationally representative controls from 2003-2004 National Health and Nutrition Examination Survey (NHANES) data.


METHODS
A prospective, longitudinal analysis of CVD risk factors in 42 HIV-infected children compared with NHANES controls, with multivariable modeling of demographic, disease-specific, and treatment-related factors contributing to cardiac risk in the HIV cohort.


RESULTS
The 42 children infected with HIV were initially an average of 10.1 years old; 68% were Centers for Disease Control and Prevention pediatric HIV disease stage B or C, and 76% were receiving highly active antiretroviral therapy (HAART). Compared with age- and sex-adjusted NHANES controls, the children infected with HIV had lower weight (-0.46 standard deviation [SD] vs +0.54 SD; P < .001), height (-0.62 SD vs +0.26 SD; P < .001), and body mass index (-0.09 SD vs +0.51 SD; P < .001), a higher level of triglycerides (136 mg/dL vs 90 mg/dL; P < .001), and a lower level of high-density lipoprotein (HDL) cholesterol (47 mg/dL vs 54 mg/dL; P < .001). Protease inhibitor therapy was independently associated with higher triglyceride (P = .02) and low-density lipoprotein cholesterol levels (P = .04) and lower HDL cholesterol level (P = .02); nonnucleoside reverse-transcriptase inhibitor therapy was associated with lower visceral fat (P = .01) and higher HDL cholesterol level (P = .005).


CONCLUSIONS
Children infected with HIV have adverse cardiac risk profiles compared with NHANES controls. Antiretroviral therapy has a significant influence on these factors.
Division of Pediatric Clinical Research, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL 33101, USA. tracie.miller@miami.edu
Tracie L
TL
Miller
E John
EJ
Orav
Steven E
SE
Lipshultz
Kristopher L
KL
Arheart
Christopher
C
Duggan
Geoffrey A
GA
Weinberg
Lori
L
Bechard
Lauren
L
Furuta
Jeanne
J
Nicchitta
Sherwood L
SL
Gorbach
Abby
A
Shevitz
D050153:Abdominal Fat / Q000000981:diagnostic imaging; D023241:Antiretroviral Therapy, Highly Active; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides