title: Carbohydrate, lipid, bone and inflammatory markers in HIV-positive adolescents on antiretroviral therapy and hormonal contraception.
abstract: BACKGROUND
  Little is known about the cumulative effect of HIV antiretroviral therapy (ART) and hormonal contraception (HC) on metabolism and inflammation in HIV-positive women.
  
  
  METHODS
  We conducted a cross-sectional assessment of markers for carbohydrate, lipid, bone metabolism, inflammation and coagulation in HIV-positive adolescents on ART and HC (n=37) versus on ART only (n=51) in Thailand. The Wilcoxon rank-sum test was used to assess differences between groups.
  
  
  RESULTS
  The median age was 19.5 years. Most adolescents (95%) were perinatally infected. All were on ART for a median of 9 years. HC used was progestin only (n=21); combined oral contraceptive (COC) tablets (n=6) for the whole study period or alternating between progestin only and COC (n=10). Prevalence of any metabolic abnormalities was 99%. Four biomarkers were significantly higher with HCvsno HC: insulin (10.3vs6.2 μU/mL,P=0.002), insulin resistance (1.89vs1.19 mass units,P=0.005), 25-OH vitamin D (33.2vs20.2 ng/mL,P<0.0001) and C-terminal telopeptide (690vs530 ng/L,P=0.011). Triglycerides and D-dimer were significantly lower with HC (103vs139 mg/dL,P=0.014 and 140vs155 ng/mL,P=0.003, respectively). There was no relationship between the type of HC or ART and the above differences.
  
  
  CONCLUSIONS
  Perinatally infected HIV-positive adolescents on ART in this pilot study had a high prevalence of metabolic abnormalities. Bone turnover markers and insulin resistance were significantly higher with HC. Research on the cumulative effect of HIV, ART and HC on metabolism and inflammation in adolescents with HIV is important in order to devise strategies for preventing and mitigating long-term comorbidities.
authors.affiliation: HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT) , Bangkok , Thailand.
authors.forename: Nadia
authors.initials: N
authors.lastname: Kancheva Landolt
authors.affiliation: HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT) , Bangkok , Thailand.
authors.forename: Torsak
authors.initials: T
authors.lastname: Bunupuradah
authors.affiliation: Chiang Rai Prachanukroh Hospital , Chiang Rai , Thailand.
authors.forename: Jullapong
authors.initials: J
authors.lastname: Achalapong
authors.affiliation: Faculty of Medicine , Khon Kaen University , Khon Kaen , Thailand.
authors.forename: Pope
authors.initials: P
authors.lastname: Kosalaraksa
authors.affiliation: Phra Chomklao Hospital Hospital , Phetchaburi , Thailand.
authors.forename: Witaya
authors.initials: W
authors.lastname: Petdachai
authors.affiliation: Phrapokklao Hospital , Chanthaburi , Thailand.
authors.forename: Chaiwat
authors.initials: C
authors.lastname: Ngampiyaskul
authors.affiliation: HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT) , Bangkok , Thailand.
authors.forename: Sasiwimol
authors.initials: S
authors.lastname: Ubolyam
authors.affiliation: HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT) , Bangkok , Thailand.
authors.forename: Narukjaporn
authors.initials: N
authors.lastname: Thammajaruk
authors.affiliation: HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Bangkok, Thailand; Department of Global Health, University of Amsterdam, Amsterdam Institute for Global Health and Development, the Netherlands.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kerr
authors.affiliation: HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Bangkok, Thailand; SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Jintanat
authors.initials: J
authors.lastname: Ananworanich