title: Echocardiography and carotid intima-media thickness among asymptomatic HIV-infected adolescents in Thailand.
abstract: OBJECTIVE
  To evaluate the carotid intima-media thickness (cIMT) in perinatally HIV-infected adolescents and factors associated with cardiovascular abnormalities.
  
  
  METHODS
  A cross-sectional study was conducted in perinatally HIV-infected adolescents who had no known cardiovascular condition and healthy controls.
  
  
  METHODS
  Transthoracic echocardiogram and cIMT measurements were taken by pediatric cardiologists. Serum lipid profiles, high-sensitivity C-reactive protein and N-terminal pro-brain natriuretic peptide were measured.
  
  
  RESULTS
  Hundred HIV-infected and 50 healthy adolescents were enrolled. Echocardiograms revealed overall normal systolic function (median left-ventricular ejection fraction 66 vs. 66%; P = 0.825). The mean overall cIMTs of common carotid arteries and internal carotid arteries were not different between the groups (0.373 vs. 0.371; P = 0.744). Among the HIV-infected adolescents, those who had been receiving protease inhibitor-containing regimens had an increased cIMT (0.364 vs. 0.381 mm; P = 0.009). Hypertriglyceridemia was found in 52% of those who had received protease inhibitors for more than 6 months, but only in 21% of those who had never received protease inhibitors (odds ratio 4.0, 95% confidence interval 1.6-9.7, P = 0.002). Current HIV-RNA, CD4, BMI, sex, cholesterol and low-density lipoprotein-cholesterol were not associated with increased cIMT. Serum high-sensitivity C-reactive protein and N-terminal pro-brain natriuretic peptide were not different between the groups and not associated with cardiac abnormalities.
  
  
  CONCLUSIONS
  Perinatally HIV-infected adolescents had comparable myocardial function and similar cIMT measurements to healthy adolescents. However, hypertriglyceridemia and increased cIMT were found in HIV-infected adolescents receiving protease inhibitor-based regimens. Longer-term follow-up is needed to evaluate HIV-associated cardiovascular disease risk in this population.
authors.affiliation: aDivision of Pediatric Cardiology bDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Prakul
authors.initials: P
authors.lastname: Chanthong
authors.forename: Keswadee
authors.initials: K
authors.lastname: Lapphra
authors.forename: Supawan
authors.initials: S
authors.lastname: Saihongthong
authors.forename: Sirintip
authors.initials: S
authors.lastname: Sricharoenchai
authors.forename: Orasri
authors.initials: O
authors.lastname: Wittawatmongkol
authors.forename: Wanatpreeya
authors.initials: W
authors.lastname: Phongsamart
authors.forename: Supattra
authors.initials: S
authors.lastname: Rungmaitree
authors.forename: Nantaka
authors.initials: N
authors.lastname: Kongstan
authors.forename: Kulkanya
authors.initials: K
authors.lastname: Chokephaibulkit
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D002097:C-Reactive Protein / Q000378:metabolism*; D059168:Carotid Intima-Media Thickness; D002648:Child; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000473:pathology*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood*; D055815:Young Adult
chemical_list: D008055:Lipids; D010446:Peptide Fragments; D014280:Triglycerides; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein