title: Subclinical atherosclerosis and markers of immune activation in HIV-infected children and adolescents: the CaroVIH Study.
abstract: BACKGROUND
  HIV-infected adults display increased cardiovascular disease, probably driven by inflammation and immune activation. These relationships have not been addressed in vertically HIV-infected children and adolescents, a population at very high risk for long-term non-AIDS complications.
  
  
  METHODS
  Carotid intima media thickness (IMT) was measured in a cohort of HIV-infected children and adolescents and healthy controls. C-reactive protein and markers of immune activation (CD38⁺HLA-DR⁺) and immune senescence (CD28⁻CD57⁺) were determined.
  
  
  RESULTS
  One hundred fifty HIV-infected patients and 150 controls were included, 64.8% female. IMT was thicker in HIV-infected patients (0.434 mm ± 0.025 vs. 0.424 mm ± 0.018, P < 0.001). After adjustment by age, sex, body mass index, and smoking status, HIV infection was independently associated with thicker IMT (odds ratio, 2.28; 95% confidence interval: 1.25 to 4.13; P = 0.007). Among HIV-related variables, a low CD4 nadir was related to an increased IMT. Although HIV-infected subjects presented higher frequencies of activated CD4⁺ and CD8⁺ T cells (P = 0.002 and P = 0.087, respectively), no relation was found between IMT and inflammation, immune activation, or senescence.
  
  
  CONCLUSIONS
  Structural changes of the vasculature present early in vertically HIV-infected subjects as well as immune activation and senescence. These patients should be carefully monitored for the prompt detection and early treatment of cardiovascular disease.
authors: *Laboratorio de InmunoBiología Molecular, Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; †Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, Spain; ‡Unidad de Cardiología Infantil, Hospital General Universitario Gregorio Marañón, Madrid, Spain; §Unidad de Inmunodeficiencias, Servicio de Pediatría, Hospital Universitario Doce de Octubre, Madrid, Spain; ‖Servicio de Pediatría, Hospital Universitario La Paz, Madrid, Spain; ¶Servicio de Pediatría, Hospital de Getafe, Madrid, Spain; #Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, and IRYCIS, Madrid, Spain; **Servicio de Pediatría, Hospital Universitario Niño Jesús, Madrid, Spain; and ††Servicio de Pediatría, Hospital Carlos III, Madrid, Spain.
authors: Talía
authors: T
authors: Sainz
authors: María
authors: M
authors: Álvarez-Fuente
authors: María Luisa
authors: ML
authors: Navarro
authors: Laura
authors: L
authors: Díaz
authors: Pablo
authors: P
authors: Rojo
authors: Daniel
authors: D
authors: Blázquez
authors: María Isabel
authors: MI
authors: de José
authors: José Tomás
authors: JT
authors: Ramos
authors: Sergio
authors: S
authors: Serrano-Villar
authors: Jorge
authors: J
authors: Martínez
authors: Constancio
authors: C
authors: Medrano
authors: María Ángeles
authors: MÁ
authors: Muñoz-Fernández
authors: María José
authors: MJ
authors: Mellado
mesh_terms: D000293:Adolescent; D000367:Age Factors; D050197:Atherosclerosis / Q000209:etiology*; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis; D018791:CD4 Lymphocyte Count; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006801:Humans; D008297:Male; D012737:Sex Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein