Metabolic disorders in vertically HIV-infected children: future adults at risk for cardiovascular disease

Abstract

Background: Despite metabolic disorders in HIV-infected children being widely described, there is still a lack of agreed criteria for diagnoses and management. Numerous studies are coming from other settings and results are heterogeneous when assessing several analytical and clinical parameters. Objectives: To describe the prevalence of metabolic disorders and associated risk factors in the Spanish National cohort of HIV-infected pediatric patients (CoRISpe). Methods: This was a cross-sectional study following all vertically HIV-infected children and adolescents in three referral centers included in the CoRISpe. Metabolic data (fasting lipids, glucose and insulin levels and thyroid hormone levels) were collected. Fat distribution was clinically assessed by expert clinicians. Results: We included 157 patients [median age 13 years, interquartile range (IQR) 10 -16]. Median duration of antiretroviral therapy was 10.2 years (IQR 5.0 -13.0). Almost 20 % of patients had insulin resistance and this was associated with hepatitis C co-infection, current use of stavudine (d4T) and hypertriglyceridemia. Hypercholesterolemia and hypertriglyceridemia were found in 23.9 % and 24.8 % of patients and were associated with current use of protease inhibitors (p = 0.042 and p = 0.022, respectively). Abnormal fat

Implementation of Occult Hepatitis Screening in the Spanish Cohort of HIV-infected Pediatric Patients

“…However, the percentage of inclusion is similar to other previously published papers on the CoRISPe population, reducing the importance of this limitation (181,182).…”

Dyslipidemia, Diet and Physical Exercise in Children on Treatment With Antiretroviral Medication in El Salvador

“…Dyslipidemia is frequent in HIV-infected children, as it has been reported in studies from North America, 1,2 South America, 3 Europe, 4 Asia 5 and Africa. 6 Dyslipidemia has been observed even in the absence of any HIV treatment, 5,6 but usually worsens with antiretroviral drugs (ART), 5,7,8 especially if protease inhibitors (PIs) are used.…”

Association of Human Immunodeficiency Virus Infection with Exposure to Highly Active Antiretroviral Therapy and Its Adverse Cardiovascular Effects

“…59 However, these same therapies have been shown to have several complications. 21,64,94,126,127 As previously detailed, altered body composition and hyperlipidemia are associated with PIs and NRTIs and may increase the risk of cardiometabolic dysfunction in children. 126,127 Lipid abnormalities vary between protease inhibitors.…”

“…21,64,94,126,127 As previously detailed, altered body composition and hyperlipidemia are associated with PIs and NRTIs and may increase the risk of cardiometabolic dysfunction in children. 126,127 Lipid abnormalities vary between protease inhibitors. Ritonavir has the most adverse effects on lipids, with a mean increase in total cholesterol concentration of 2.0 mmol/L and a mean increase in triglyceride concentration of 1.83 mmol/L.…”