title: Association between human immunodeficiency virus infection and arterial stiffness in children.
abstract: Background Human immunodeficiency virus infection (HIV) is associated with increased cardiovascular risk and adverse cardiovascular outcome in adults. Early recognition of changes in vascular properties might prove essential in cardiovascular prevention in HIV-infected patients. We investigated the relations between HIV infection and arterial stiffness in children. Methods This cross-sectional study included 51 HIV-infected and 52 healthy children (age 3.2-14.5 years, 49 males). All infected children had acquired HIV by vertical transmission and were receiving antiretroviral therapy at time of assessment. Arterial stiffness was measured by pulse wave velocity and aortic augmentation index, using the Arteriograph system (Tensiomed Kft, Budapest, Hungary). We applied multivariable general linear modeling to evaluate the relationship between HIV infection and arterial stiffness with further adjustment for confounders and possible intermediary variables. Findings represent mean group differences with 95% confidence intervals and p values. Results Aortic augmentation index was higher by 9.0% (5.6-12.5, p < 0.001) in HIV-infected than in healthy children. Adjustment for blood pressure, protease inhibitor use, biomarkers for level of inflammation, lipid- and glucose-metabolism, as possible intermediary variables, did not appreciably alter the results. There were no significant differences in pulse wave velocity between HIV-infected and healthy children (mean difference 0.28 m/s, -0.14-0.69, p = 0.19). Conclusion HIV-infected children have an increased aortic augmentation index, compared to healthy children. Early cardiovascular assessment may be important in targeted prevention for HIV-infected children.
authors.affiliation: 1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.
authors.forename: Justin S
authors.initials: JS
authors.lastname: Kuilder
authors.affiliation: 1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.|2 Department of Child Health, Universitas Indonesia, Indonesia.|3 Murdoch Childrens Research Institute/ University of Melbourne, Australia.
authors.forename: Nikmah S
authors.initials: NS
authors.lastname: Idris
authors.affiliation: 1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.affiliation: 1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.affiliation: 3 Murdoch Childrens Research Institute/ University of Melbourne, Australia.|4 Department of Cardiology, Royal Children's Hospital, Australia.
authors.forename: Michael Mh
authors.initials: MM
authors.lastname: Cheung
authors.affiliation: 3 Murdoch Childrens Research Institute/ University of Melbourne, Australia.|5 Department of Paediatrics, Monash University, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Burgner
authors.affiliation: 2 Department of Child Health, Universitas Indonesia, Indonesia.
authors.forename: Nia
authors.initials: N
authors.lastname: Kurniati
authors.affiliation: 1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.
authors.forename: Cuno Spm
authors.initials: CS
authors.lastname: Uiterwaal
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011379:Prognosis; D012016:Reference Values; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D059289:Vascular Stiffness / Q000502:physiology*
keywords: Human immunodeficiency virus; arterial elasticity; cardiovascular risk; children