Heightened inflammation is linked to carotid intima-media thickness and endothelial activation in HIV-infected children.
OBJECTIVE
HIV+ patients are at increased risk of cardiovascular disease (CVD). Inflammation plays a role in adults, but has not yet been assessed in HIV+ children. We compared proinflammatory cytokines and adhesion molecules in HIV+ children versus healthy controls, and assessed their relationship to carotid intima-media thickness (IMT).


METHODS
Evaluations were performed on 27 HIV+ children and 30 HIV-healthy controls (2-21 years) who were prospectively enrolled in our pediatric cohort. Measurements included internal carotid artery (ICA) and common carotid artery (CCA) IMT, fasting lipids, insulin, proinflammatory markers (TNF-alpha, soluble TNF receptors (sTNFR-I, -II), IL-6, high sensitivity C-reactive protein (hsCRP), myeloperoxidase (MPO)), and adhesion molecules (soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1 (sVCAM-1), von Willebrand factor).


RESULTS
Among HIV+, mean age was 11 years, 33% males, 70% black. 96% acquired HIV vertically; median CD4 count (CD4%) was 1058 (35%) cells/ml; 96% were on antiretroviral therapy (ART); 70% had HIV-1 RNA <50copies/ml. Groups were similar in age, race, sex, BMI, proinflammatory cytokines, adhesion markers, and carotid IMT except for hsCRP which was higher in HIV+ (P<0.001). In multiple regression analyses, hCRP, age, and female sex were positively associated with IMT. ART duration and sTNFR-II were positively associated with sVCAM-1.


CONCLUSIONS
This study shows increased hsCRP in HIV+ children compared to healthy controls. As seen in adults, hCRP was associated with carotid IMT, which support a role for inflammation in CVD risk of HIV+ children.
Ross
Allison C
AC
Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA. across3@emory.edu
O'Riordan
Mary Ann
MA
Storer
Norma
N
Dogra
Vikram
V
McComsey
Grace A
GA
D000293:Adolescent; D000328:Adult; D002339:Carotid Arteries / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000473:pathology*; D006801:Humans; D007223:Infant; D007249:Inflammation; D008297:Male; D011446:Prospective Studies; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*