Associations of proinflammatory cytokine levels with lipid profiles, growth, and body composition in HIV-infected children initiating or changing antiretroviral therapy.
OBJECTIVE
To measure proinflammatory cytokines (PIC) in HIV-infected children beginning or changing antiretroviral therapy (ART), evaluating associations with virologic, immunologic, serum lipid, growth, and body composition measures, markers of growth hormone action and glucose metabolism.


METHODS
Forty-nine prepubertal HIV-infected children had measurements of viral load (VL), CD4 lymphocyte count and percentage, serum lipids, apolipoprotein AI/B, IGF-1, IGFBP-1, and IGFBP-3, anthropometry, bioelectrical impedance analysis, TNF-α, IL-1 β, and IL-6 at baseline and 48 weeks of ART.


RESULTS
Baseline levels were detectable (>0.1 pg/mL) for IL-1 β in 28 of 48, and for TNF-α and Il-6 in all 49 children. TNF-α decreased with ART (P < 0.001) and IL-6 demonstrated a similar trend (P = 0.065). Children with 48-week VL <400 copies/mL had greater declines in TNF-α (mean 45%) than subjects with higher VL (5%; P = 0.009). Each 10% improvement in CD4% was associated with 26% lower TNF-α (P = 0.002) and 31% lower IL-6 (P = 0.016). Greater reductions in TNF-α were associated with lower total/HDL cholesterol ratio (P = 0.003) at week 48.


CONCLUSIONS
In HIV-infected children initiating or changing ART, PIC were detectable at baseline and decreased over 48 weeks. Better immunologic responses were associated with greater reductions in TNF-α and IL-6. Reductions in TNF-α were associated with improved total/HDL cholesterol ratio.
Cervia
Joseph S
JS
Albert Einstein College of Medicine, Bronx, NY 11030, USA. cervia@lij.edu
Chantry
Caroline J
CJ
Hughes
Michael D
MD
Alvero
Carmelita
C
Meyer
William A
WA
Hodge
Janice
J
Borum
Peggy
P
Moye
Jack
J
Spector
Stephen A
SA
D000886:Anthropometry; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001823:Body Composition; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D017097:Electric Impedance; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology* / Q000821:virology; D006801:Humans; D007223:Infant; D008055:Lipids / Q000097:blood*; D008297:Male; D019562:Viral Load
D019380:Anti-HIV Agents; D016207:Cytokines; D008055:Lipids