Complications of Treatment in Youth with HIV

Eckard, Allison Ross; Fowler, Sandra L.; Haston, Julia C.; Dixon, Terry C.

doi:10.1007/s11904-016-0320-1

Cited by 7 publications

(8 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar to their adult counterparts, data show that HIV-1-infected youth are also at an increased risk of development of these HIV-related comorbidities later in life, despite few clinical manifestations at their younger age [4][5][6]. Previous data, including our own, have shown that this population exhibits a comparable pattern of increased immune activation and exhaustion as HIV-1-infected adults [7].…”

supporting

confidence: 63%

Vitamin D Supplementation Decreases Immune Activation and Exhaustion in HIV-1-Infected Youth

et al. 2017

Self Cite

View full text Add to dashboard Cite

Vitamin D supplementation decreased markers of T-cell activation/exhaustion and monocyte activation in HIV-infected youth, with subjects given the highest dose (120,000 IU/month) showing the greatest decreases. These data suggest that high-dose vitamin D supplementation may attenuate immune activation and exhaustion, and serve as adjuvant therapy to antiretroviral therapy in HIV. ClinicalTrials.gov identifier: NCT01523496.

show abstract

supporting

confidence: 63%

Vitamin D Supplementation Decreases Immune Activation and Exhaustion in HIV-1-Infected Youth

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Complications potentially related to long-term antiretroviral therapy, including anemia, pancreatitis, hepatitis, peripheral neuropathy, and metabolic and bone abnormalities, were documented infrequently, likely reflecting use of less toxic ARVs over time. 35,51 …”

Section: Discussionmentioning

confidence: 99%

Association of Risk of Viremia, Immunosuppression, Serious Clinical Events, and Mortality With Increasing Age in Perinatally Human Immunodeficiency Virus–Infected Youth

et al. 2017

View full text Add to dashboard Cite

IMPORTANCE As perinatally human immunodeficiency virus-infected youth (PHIVY) in the United States grow older and more treatment experienced, clinicians need updated information about the association of age, CD4 cell count, viral load (VL), and antiretroviral (ARV) drug use with risk of opportunistic infections, key clinical events, and mortality to understand patient risks and improve care. OBJECTIVE To examine the incidence or first occurrence during follow-up of key clinical events (including Centers for Disease Control and Prevention stage B [CDC-B] and stage C [CDC-C] events) and mortality among PHIVY stratified by age, CD4 cell count, and VL and ARV status. DESIGN, SETTING, AND PARTICIPANTS Combining data from the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol and International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) P1074 multicenter cohort studies (March 2007 through April 2015), we estimated event rates during person-time spent in key strata of age (7-12, 13-17, and 18-30 years), CD4 cell count (<200, 200-499, and Ն500/μL), and a combined measure of VL and ARV status (VL <400 or Ն400 copies/mL; ARV therapy or no ARV therapy). A total of 1562 participants in the PHACS Adolescent Master Protocol and IMPAACT P1074 were eligible, and 1446 PHIVY from 41 ambulatory sites in the 12 US states, including Puerto Rico were enrolled. The dates of analysis were March 2015 through January 2017. MAIN OUTCOMES AND MEASURES Clinical event rates stratified by person-time in age, CD4 cell count, and VL and ARV categories. RESULTS A total of 1446 PHIVY participated in the study (mean [SD] age, 14.6 [4.6] years; 759 female [52.5%]; 953 black [65.9%]). During a mean (SD) follow-up of 4.9 (1.3) years, higher incidences of CDC-B events, CDC-C events, and mortality were observed as participants aged. Older PHIVY (aged 13-17 and 18-30 years) spent more time with a VL of 400 copies/mL or more and with a CD4 cell count of less than 200/μL compared with 7-to 12-year-old participants (30% and 44% vs 22% of person-time with a VLՆ400 copies/mL; 5% and 18% vs 2% of person-time with CD4 cell count <200/μL; P < .001 for each comparison). We observed higher rates of CDC-B events, CDC-C events, bacterial infections, and mortality at lower CD4 cell counts, as expected. The mortality rate among older PHIVY was 6 to 12 times that among the general US population. Higher rates of sexually transmitted infections were also observed at lower CD4 cell counts after adjusting for age. CONCLUSIONS AND RELEVANCEOlder PHIVY were at increased risk of viremia, immunosuppression, CDC-B events, CDC-C events, and mortality. Interventions to improve ARV therapy adherence and optimize models of care for PHIVY as they age are urgently needed to improve long-term outcomes among PHIVY.

show abstract

“…The lower concentrations we report in HIV-infected youth versus healthy uninfected controls could potentially be explained by differences in intestinal absorption, amino acid utilization, and/or amino acid requirements; however, further studies are required to delineate these possibilities. In one small pre-cART study investigating protein metabolism in six HIV-infected children, there was an increased protein catabolism compared to the controls, but no (10,26) 17 (11,24) 16 (10,23) .90 16 (11,24) .589 Glutamate 60 (28,78) 71 (45,91) 70 (54,81) .08 71 (53,88) .022…”

Section: Discussionmentioning

confidence: 99%

“…Glutathione improvement was accompanied by marked improvements in mitochondrial fuel oxidation, insulin sensitivity, body composition, anthropometry, muscle strength, and dyslipidemia, 52 all metabolic disorders also known to affect HIV-infected children and young adults. 53,54 In this study, we also investigated associations between individual amino acid concentrations and specific inflammatory and cardiovascular markers. Previous studies evaluating children with other disease states have shown an association between the plasma concentrations of arginine and citrulline and markers of inflammation.…”

Section: Discussionmentioning

confidence: 99%

Amino Acid Concentrations in HIV-Infected Youth Compared to Healthy Controls and Associations with CD4 Counts and Inflammation

Ziegler

Judd

Ruff

et al. 2017

AIDS Research and Human Retroviruses

Self Cite

View full text Add to dashboard Cite

Amino acids play critical roles in metabolism, cell function, body composition and immunity, but little data on plasma amino acid concentrations in HIV are available. We evaluated plasma amino acid concentrations and associations with CD4 counts and inflammatory biomarkers in HIV-infected youth. HIV-infected subjects with a high (≥500 cells/mm) and low (<500 cells/mm) current CD4 T cell counts were compared to one another and to a matched healthy control group. Plasma concentrations of 19 amino acids were determined with an amino acid analyzer. Plasma levels of interleukin-6, tumor necrosis factor receptor-I, and soluble vascular cellular adhesion molecule-I were also measured. Seventy-nine HIV-infected subjects (40 and 39 with high and low CD4 T cell counts, respectively) and 40 controls were included. There were no differences in amino acid concentrations between HIV-infected subjects with high or low CD4 T cell counts. When combined, the HIV-infected group exhibited significantly lower median plasma concentrations compared to controls for total, essential, branched-chain and sulfur amino acids, as well as for 12 individual amino acids. Glutamate was the only amino acid that was higher in the HIV-infected group. There were no significant correlations between amino acid endpoints and inflammatory biomarkers for either HIV-infected group or controls. Plasma amino acid concentrations were lower in HIV-infected youth compared to healthy controls, regardless of immune status, while glutamate concentrations were elevated. These findings can inform future interventional studies designed to improve metabolic and clinical parameters influenced by amino acid nutriture.

show abstract

Complications of Treatment in Youth with HIV

Cited by 7 publications

References 48 publications

Vitamin D Supplementation Decreases Immune Activation and Exhaustion in HIV-1-Infected Youth

Vitamin D Supplementation Decreases Immune Activation and Exhaustion in HIV-1-Infected Youth

Association of Risk of Viremia, Immunosuppression, Serious Clinical Events, and Mortality With Increasing Age in Perinatally Human Immunodeficiency Virus–Infected Youth

Amino Acid Concentrations in HIV-Infected Youth Compared to Healthy Controls and Associations with CD4 Counts and Inflammation

Contact Info

Product

Resources

About