Biomarkers of vascular dysfunction in children infected with human immunodeficiency virus-1.
BACKGROUND
: We compared biomarkers of vascular dysfunction among HIV-infected children to a demographically similar group of uninfected children and determined factors associated with these biomarkers.


RESULTS
: We measured several biomarkers of vascular dysfunction: C-reactive protein (CRP), interleukin-6 (IL-6), and monocyte chemoattractant protein -1 (MCP-1) (inflammation); fibrinogen and P-selectin (coagulant dysfunction); soluble intracellular cell adhesion molecule-1 (sICAM), soluble vascular cell adhesion molecule-1 (sVCAM), and E-selectin (endothelial dysfunction); and leptin (metabolic dysfunction). Anthropometry, body composition, CD4%, HIV viral load, and antiretroviral therapy were recorded. Mean age was 14.8 years (106 HIV-infected children) and 12.3 years (55 control children). Sex and body mass index Z scores were similar. Infected children had higher sICAM, sVCAM, MCP-1, IL-6, and fibrinogen levels. E-selectin (P = 0.07), and CRP (P = 0.08) trended to be greater in the HIV group, yet leptin and P-selectin were similar. In multivariable analyses in the HIV-infected children alone, each 1 standard deviation increase in waist to hip ratio was associated with increases in sICAM (17%), MCP-1 (19%), IL6 (18%), and CRP (59%). CD4% was inversely associated with sVCAM, MCP-1, IL6, fibrinogen, and CRP.


CONCLUSIONS
: HIV-infected children have higher levels of biomarkers of vascular dysfunction than healthy children. Risk factors associated with these biomarkers include higher waist to hip ratios and HIV disease severity.
Division of Pediatric Clinical Research, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL, USA.
Tracie L
TL
Miller
Gabriel
G
Somarriba
E John
EJ
Orav
Armando J
AJ
Mendez
Daniela
D
Neri
Natasha
N
Schaefer
Lourdes
L
Forster
Ronald
R
Goldberg
Gwendolyn B
GB
Scott
Steven E
SE
Lipshultz
D000293:Adolescent; D015415:Biomarkers / Q000097:blood*; D001808:Blood Vessels / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000097:blood; D002648:Child; D019040:E-Selectin / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D015658:HIV Infections / Q000097:blood* / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D020738:Leptin / Q000097:blood; D008297:Male; D015999:Multivariate Analysis; D019007:P-Selectin / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D049629:Waist-Hip Ratio
D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D019040:E-Selectin; D020738:Leptin; D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D005340:Fibrinogen; D002097:C-Reactive Protein