Effects of highly active antiretroviral therapy (HAART) on cholesterol in HIV‐1 infected children: a retrospective cohort study

Kim, Jason Y.; Zaoutis, Theoklis E.; Chu, Jaclyn; Zhao, Huaqing; Rutstein, Richard M.

doi:10.1002/pds.1755

Cited by 18 publications

(14 citation statements)

References 21 publications

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“…Stable ART regimens have shown varied effects on HDL in children (8,13,14,19), notably decreasing TC:HDL ratio in a predominantly African population (9). No change was noted in TC:HDL ratio at 12 months in the present study.…”

Section: Discussioncontrasting

confidence: 77%

Early Increases in Concentrations of Total, LDL, and HDL Cholesterol in HIV‐infected Children Following New Exposure to Antiretroviral Therapy

Sztam

Jiang

Jurgrau

et al. 2011

J. pediatr. gastroenterol. nutr.

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Antiretroviral therapy (ART) is associated with dyslipidemia and cardiovascular disease in adults infected with HIV. For children perinatally infected with HIV, ART exposure is lifelong and early-onset dyslipidemia could have significant long-term effects. We examined cholesterol levels in children during the first year after exposure to a new ART regimen (initiation or switch). In 52 children, total cholesterol increased by 30.5 and 43 mg/dL at 6 and 12 months, respectively (P < 0.001). Low-density lipoprotein cholesterol made the largest contribution, but high-density lipoprotein cholesterol also increased within months of therapy alteration. Early identification of these children and intervention could mediate potential increased risk for future cardiovascular disease.

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Section: Discussioncontrasting

confidence: 77%

Early Increases in Concentrations of Total, LDL, and HDL Cholesterol in HIV‐infected Children Following New Exposure to Antiretroviral Therapy

Sztam

Jiang

Jurgrau

et al. 2011

J. pediatr. gastroenterol. nutr.

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“…30 In a single site study of 178 children on CART, 72.8% had TC >180 mg/dL and 53.4% had TC >199 mg/dL. 31 In both pediatric studies, use of a PI was associated with elevated TC.…”

Section: Resultsmentioning

confidence: 98%

Long-term Safety and Efficacy of Atazanavir-based Therapy in HIV-infected Infants, Children and Adolescents

Rutstein

Samson

Fenton

et al. 2015

Pediatric Infectious Disease Journal

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Background Atazanavir is an attractive option for the treatment of Pediatric HIV infection, based on once daily dosing and the availability of a formulation appropriate for younger children. PACTG 1020A was a phase I/II open label study of atazanavir (ATV) (with/without ritonavir [RTV] boosting)-based treatment of HIV-infected children; here we report the long-term safety and virologic and immunologic responses. Methods Antiretroviral-naïve and experienced children, ages 91 days to 21 years, with baseline plasma HIV RNA >5000 copies/ml (cpm) were enrolled at sites in the United States and South Africa. Results Of 195 children enrolled 142 (73%) subjects received ATV-based regimens at the final protocol recommended dose. 58% were treatment naive. Overall, at week 24, 84/139 subjects (60.4%) and at week 48, 83/142 (58.5%), had HIV RNA ≤400 cpm. At week 48, 69.5% of naïve and 43.3% of experienced subjects had HIV RNA ≤400 cpm; median CD4 increase was 196.5 cells/mm3. The primary adverse event was increased serum bilirubin; 9% of subjects had levels > 5.1 times upper limit of normal and 1.4% noted jaundice. 3% of subjects experienced Grade 2 or 3 prolongation in PR or QTc intervals. At week 48, there was a 15% increase in total cholesterol (TC), with TC >199 mg/dL increasing from 1% at baseline to 5.7%. Conclusions Use of once-daily ATV, with/without RTV, was safe and well tolerated in children, with acceptable levels of viral suppression and CD4 count increase. The primary adverse event, as expected, was an increase in bilirubin levels.

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“…Entretanto, um estudo retrospectivo em crianças infectadas pelo HIV no período perinatal encontrou alteração no colesterol quando a mediana do tempo de uso da droga era de 1,61 e 4,65 anos para valores acima de 180 e 200 mg/dL, respectivamente, sendo essa alteração independente do tratamento com HAART 21 . Um estudo com 21 pacientes de 1 a 17 anos portadores de HIV usando IP verificou que 12 pacientes que usaram ritonavir ou nelfinavir desenvolveram alteração nas concentrações de colesterol total e de TG sanguíneo 22 .…”

Section: Discussionunclassified

“…: (21) 2554.1718 E-mail: mluizafw@iff.fiocruz.br dados disponíveis sobre o uso de estatinas em crianças são limitados. Além disso, seu uso associado a determinadas drogas antirretrovirais é contraindicado porque ao interferir com o citrocromo P450 leva a uma inadequada supressão da carga viral ou a uma maior toxicidade da droga 4 .…”

Section: Discussionunclassified

Lipodystrophy syndrome and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy

Werner¹,

Pone²,

Fonseca³

et al. 2010

J Pediatr (Rio J)

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Objective: To describe lipid profile, body shape changes, and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy. Methods:We investigated 43 children and adolescents being treated with this therapy at the outpatient clinic of pediatric infectious diseases of Instituto Fernandes Figueira/Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. Values of total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides were determined. We also performed glucose tolerance test and analyzed body fat distribution, nutritional status, dietary intake, and family history of cardiovascular risk. The statistical analysis was performed using Student's t test. Significance level of pvalue was lower than 0.05. Results:We found lipid abnormality in 88.3% and body shape change in 13.9% of the cases. Nutritional status was adequate (81.3%) in most of the study population. Cholesterol intake in children older than 9 years was above the recommended value. Conclusion:Prevalence of dyslipidemia and, therefore, risk for cardiovascular diseases were high during the use of highly active antiretroviral therapy.J Pediatr (Rio J). 2010;86(1):27-32: Lipodystrophy, HIV, cardiovascular diseases, children, adolescents. ResumoObjetivo: Descrever o perfil lipídico, alterações da conformação corporal e fatores de risco cardiovasculares em crianças e adolescentes infectados pelo HIV/AIDS, tratados com terapia antirretroviral de alta potência. Métodos:Foram estudadas 43 crianças e adolescentes em uso dessa terapia atendidas no ambulatório de doenças infecciosas em Pediatria do Instituto Fernandes Figueira/Fundação Oswaldo Cruz, Rio de Janeiro (RJ). Foram realizadas dosagens de colesterol total, lipoproteína de alta densidade, lipoproteína de baixa densidade, triglicerídeos, teste de tolerância à glicose e avaliada a distribuição de gordura corporal, estado nutricional, ingestão dietética e história familiar de risco cardiovascular. As análises estatísticas foram realizadas com o teste t de Student. O nível de significância estatístico do p foi menor que 0,05.Resultados: Observou-se alteração lipídica em 88,3% e de conformação corporal em 13,9% dos casos. O estado nutricional foi adequado na maioria (81,3%) da população do estudo. A ingestão de colesterol em crianças com mais de 9 anos foi acima do recomendado. Conclusão:A prevalência de dislipidemia e, consequentemente, o risco para doenças cardiovasculares foram altos durante o uso de terapia antirretroviral de alta potência.

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Effects of highly active antiretroviral therapy (HAART) on cholesterol in HIV‐1 infected children: a retrospective cohort study

Abstract: In vertically acquired HIV-1 infected children, HAART elevates the risk of hypercholesterolemia. NRTI/PI increased risk of TC levels threefold, while NRTI/NNRTI increased risk twofold over No MED.

Cited by 18 publications

References 21 publications

Early Increases in Concentrations of Total, LDL, and HDL Cholesterol in HIV‐infected Children Following New Exposure to Antiretroviral Therapy

Early Increases in Concentrations of Total, LDL, and HDL Cholesterol in HIV‐infected Children Following New Exposure to Antiretroviral Therapy

Long-term Safety and Efficacy of Atazanavir-based Therapy in HIV-infected Infants, Children and Adolescents

Lipodystrophy syndrome and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy

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