title: Lipid changes in Kenyan HIV-1-infected infants initiating highly active antiretroviral therapy by 1 year of age.
abstract: BACKGROUND
  Early highly active antiretroviral therapy (HAART) is recommended for HIV-1-infected infants. There are limited data on lipid changes during infant HAART.
  
  
  METHODS
  Nonfasting total (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol and triglycerides (TG) were measured at 0, 6 and 12 months. Correlates of lipid levels and changes post-HAART were assessed using linear regression.
  
  
  RESULTS
  Among 115 infants, pre-HAART median age was 3.8 months, CD4% was 19% and weight-for-age Z score was -2.42. Pre-HAART median lipid levels were: TC, 108.7 mg/dL; LDL, 42.5 mg/dL; HDL, 29.4 mg/dL and TG, 186.9 mg/dL. Few infants had abnormally high TC (6.2%) or LDL (5.6%), but many had low HDL (76.5%) or high TG (69.6%). Higher pre-HAART weight-for-age and height-for-age Z scores were each associated with higher pre-HAART TC (P = 0.04 and P = 0.01) and LDL (P = 0.02 and P = 0.008). From 0 to 6 months post-HAART, TC (P < 0.0001), LDL (P < 0.0001) and HDL (P < 0.0001) increased significantly, and 23.1% (P = 0.002), 14.0% (P = 0.2), 31.3% (P < 0.0001) and 50.8% (P = 0.2) of infants had abnormally high TC, high LDL, low HDL and high TG, respectively. Changes in TC and HDL were each associated with higher gain in weight-for-age Z score (P = 0.03 and P = 0.01) and height-for-age Z score (P = 0.01 and P = 0.007). Increased change in LDL was associated with higher gain in height-for-age Z score (P = 0.03). Infants on protease inhibitor-HAART had smaller HDL increase (P = 0.004).
  
  
  CONCLUSIONS
  Infants had substantive increases in lipids, which correlated with growth. Increases in HDL were attenuated by protease inhibitor-HAART. It is important to determine clinical implications of these changes.
authors: Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
authors: Agnes
authors: A
authors: Langat
authors: Sarah
authors: S
authors: Benki-Nugent
authors: Dalton
authors: D
authors: Wamalwa
authors: Ken
authors: K
authors: Tapia
authors: Evelyn
authors: E
authors: Ngugi
authors: Lara
authors: L
authors: Diener
authors: Barbra A
authors: BA
authors: Richardson
authors: Ann
authors: A
authors: Melvin
authors: Grace C
authors: GC
authors: John-Stewart
mesh_terms: D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007630:Kenya; D008055:Lipids / Q000097:blood*; D008297:Male
chemical_list: D044966:Anti-Retroviral Agents; D008055:Lipids
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