Serum uric acid in HIV infected children and correlation to cardiovascular risk factors

Abstract

Introduction: Serum uric acid (SUA) has been reported to be associated with hypertension and metabolic syndrome. Metabolic disorders leading to increased cardiovascular risk are often observed in human immunodeficiency virus (HIV)-infected children. The aim of the study was to assess the level of SUA and its association with metabolic abnormalities and high blood pressure. Material and methods: Fasting SUA, total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), insulin, and glucose measurements were performed in 54 HIV-infected children (mean age 12.3 years), 46% male. All but two were treated with highly active antiretroviral therapy (HAART). HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) was calculated using the formula HOMA-IR = (insulin [mU/l] × glucose [mmol/l])/22.5. All children underwent anthropometric measurements. Body mass index (BMI) was calculated by dividing weight in kilograms by square of height in metres. Results: Mean SUA was 239.8 μmol/l, and no patient showed hiperuricaemia. SUA was higher in boys and in older children. Nadir immunologic category 3 was associated with higher SUA compared to category 1 and 2 together. Children with abnormal triglycerides, HDL-C, insulin, and HOMA-IR had significantly higher SUA. Regression analysis showed that all metabolic parameters apart from HDL-C influence SUA. Children treated with HAART based on non-nucleoside reverse transcriptase inhibitors (NNRTIs) had lower SUA in contrast to children receiving a protease inhibitor (PI)-based or other HAART scheme. We did not observe any association between SUA and high blood pressure. Conclusions: We showed correlation between SUA and metabolic parameters in HIV-infected children. Metabolic abnormalities are the result of both HIV infection and antiretroviral treatment. Association of SUA with CD4 nadir and HAART may indicate the effect of HIV itself or its treatment.