Earlier antiretroviral initiation is independently associated with better arterial stiffness in children living with perinatally acquired HIV with sustained viral suppression in Mozambique.
arteriosclerosis
large arterial elasticity
long-term ART
pulse wave velocity
viral suppression
Journal
Southern African journal of HIV medicine
ISSN: 2078-6751
Titre abrégé: South Afr J HIV Med
Pays: South Africa
ID NLM: 100965417
Informations de publication
Date de publication:
2021
2021
Historique:
received:
29
06
2021
accepted:
30
08
2021
entrez:
3
12
2021
pubmed:
4
12
2021
medline:
4
12
2021
Statut:
epublish
Résumé
Cardiovascular disease is a major driver of morbidity and mortality in adults living with HIV. The drivers of cardiovascular disease in children living with perinatally acquired HIV (PHIV) with sustained HIV viral suppression are unclear. We explored the contribution of HIV-specific risk factors to arterial stiffness independently of traditional risk factors (metabolic syndrome [MetS]) in prepubertal children with PHIV with sustained viral suppression in a low-income country in Africa. For this cross-sectional analysis, arterial stiffness was assessed by pulse wave velocity We studied 77 virally suppressed children with PHIV without evidence of cardiovascular disease (from medical history and physical examination). In the initial model, the PWVz was independently associated with each MetS component. The PWVz was higher in participants with proportionally greater visceral fat (waist/height ratio), elevated lipids (triglyceride/high-density lipoprotein ratio) and insulin resistance (log homeostatic model assessment [HOMA]). The addition of age at ART initiation increased the model Earlier ART initiation was independently associated with lower large artery stiffness. This effect was independent of the effect of elevated lipids, visceral fat and insulin resistance.
Sections du résumé
BACKGROUND
BACKGROUND
Cardiovascular disease is a major driver of morbidity and mortality in adults living with HIV. The drivers of cardiovascular disease in children living with perinatally acquired HIV (PHIV) with sustained HIV viral suppression are unclear.
OBJECTIVES
OBJECTIVE
We explored the contribution of HIV-specific risk factors to arterial stiffness independently of traditional risk factors (metabolic syndrome [MetS]) in prepubertal children with PHIV with sustained viral suppression in a low-income country in Africa.
METHOD
METHODS
For this cross-sectional analysis, arterial stiffness was assessed by pulse wave velocity
RESULTS
RESULTS
We studied 77 virally suppressed children with PHIV without evidence of cardiovascular disease (from medical history and physical examination). In the initial model, the PWVz was independently associated with each MetS component. The PWVz was higher in participants with proportionally greater visceral fat (waist/height ratio), elevated lipids (triglyceride/high-density lipoprotein ratio) and insulin resistance (log homeostatic model assessment [HOMA]). The addition of age at ART initiation increased the model
CONCLUSION
CONCLUSIONS
Earlier ART initiation was independently associated with lower large artery stiffness. This effect was independent of the effect of elevated lipids, visceral fat and insulin resistance.
Identifiants
pubmed: 34858652
doi: 10.4102/sajhivmed.v22i1.1282
pii: 1282
pmc: PMC8603154
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1282Subventions
Organisme : NIAID NIH HHS
ID : P30 AI036214
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD083042
Pays : United States
Informations de copyright
© 2021. The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.
Références
Circulation. 2014 Mar 18;129(11):1204-12
pubmed: 24366631
Clin Infect Dis. 2020 Dec 15;71(12):3025-3032
pubmed: 31807748
Atherosclerosis. 2015 Jan;238(1):9-16
pubmed: 25461733
J Am Coll Cardiol. 2010 Mar 30;55(13):1318-27
pubmed: 20338492
AIDS. 2007 May 11;21(8):921-7
pubmed: 17457085
Curr Opin HIV AIDS. 2018 May;13(3):187-195
pubmed: 29432231
Antivir Ther. 2009;14(8):1075-9
pubmed: 20032537
J Obes. 2018 Nov 1;2018:8370304
pubmed: 30515323
Lancet. 2013 Nov 9;382(9904):1555-63
pubmed: 24209829
Diabetes Care. 2007 Jul;30(7):1851-6
pubmed: 17440172
AIDS. 2012 Aug 24;26(13):1685-90
pubmed: 22614886
Pediatr Infect Dis J. 2016 Jan;35(1):e1-7
pubmed: 26421804
J Biomech. 2013 May 31;46(9):1540-7
pubmed: 23623314
Lancet. 2005 Sep 24-30;366(9491):1059-62
pubmed: 16182882
J Hypertens. 2014 Jul;32(7):1464-9; discussion 1469
pubmed: 24759123
Ann Hum Biol. 1989 Sep-Oct;16(5):407-19
pubmed: 2802520
N Engl J Med. 2008 Nov 20;359(21):2233-44
pubmed: 19020325
J Infect Dis. 2019 May 24;219(12):1948-1958
pubmed: 30629187
Am J Hypertens. 2014 Jun;27(6):865-72
pubmed: 24390294
BMC Cardiovasc Disord. 2021 Feb 16;21(1):97
pubmed: 33593274
Am J Hypertens. 2011 Dec;24(12):1294-9
pubmed: 21866186
Pediatrics. 2017 Aug;140(2):
pubmed: 28739653
BMC Infect Dis. 2018 Dec 29;18(1):708
pubmed: 30594160
HIV Med. 2012 Sep;13(8):453-68
pubmed: 22413967
Diabetes Care. 2001 Mar;24(3):460-4
pubmed: 11289468