Metabolic abnormalities and viral replication are associated with biomarkers of vascular dysfunction in HIV-infected children.
Metabolic abnormalities and viral replication are associated with biomarkers of vascular dysfunction in HIV-infected children.
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DOI：
10.1111/j.1468-1293.2011.00970.x
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发表时间：
2012-05
期刊：
影响因子：
3
通讯作者：
Willen E
中科院分区：
文献类型：
--
作者：
Miller TI;Borkowsky W;DiMeglio LA;Dooley L;Geffner ME;Hazra R;McFarland EJ;Mendez AJ;Patel K;Siberry GK;Van Dyke RB;Worrell CJ;Jacobson DL;Pediatric HIV/AIDS Cohort Study (PHACS);Shearer W;Cooper N;Harris L;Purswani M;Baig M;Cintron A;Puga A;Navarro S;Patton D;Burchett S;Karthas N;Kammerer B;Yogev R;Malee K;Hunter S;Cagwin E;Wiznia A;Burey M;Nozyce M;Chen J;Gobs E;Grant M;Knapp K;Allison K;Garvie P;Acevedo-Flores M;Rios H;Olivera V;Silio M;Borne C;Sirois P;Spector S;Norris K;Nichols S;McFarland E;Barr E;Chambers C;Watson D;Messenger N;Belanger R;Dieudonne A;Bettica L;Adubato S;Scott G;Himic L;Willen E
Human immunodeficiency virus (HIV)-infected children may be at risk for premature cardiovascular disease. We compared levels of biomarkers of vascular dysfunction among HIV-infected children with and without hyperlipidemia to HIV-exposed, uninfected children (HEU) enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS), and determined factors associated with these biomarkers. Prospective cohort study Biomarkers of inflammation (C-reactive protein (CRP), interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP1)); coagulant dysfunction (fibrinogen and P-selectin); endothelial dysfunction (soluble intracellular cell adhesion molecule-1 (sICAM), soluble vascular cell adhesion molecule-1 (sVCAM), and E-selectin); and metabolic dysfunction (adiponectin) were measured in 226 HIV-infected and 140 HEU children. Anthropometry, body composition, lipids, glucose, insulin, HIV disease severity, and antiretroviral therapy were recorded. The median ages were 12.3 y (HIV-infected) and 10.1 y (HEU). Body mass index (BMI) Z-scores, waist and hip circumference, and percent body fat were lower among HIV-infected. Total and non-HDL cholesterol and triglycerides were higher in HIV-infected children. HIV-infected children had higher MCP-1, fibrinogen, sICAM, and sVCAM levels. In multivariable analyses in the HIV-infected children alone, BMI z-score was associated with higher CRP and fibrinogen, but lower MCP-1 and sVCAM. Unfavorable lipid profiles were positively associated with IL6, MCP1, fibrinogen, and P- and E-selectin, whereas increased HIV viral load was associated with markers of inflammation (MCP1 and CRP) and endothelial dysfunction (sICAM and sVCAM). HIV-infected children have higher levels of biomarkers of vascular dysfunction than do HEU children. Risk factors associated with higher biomarkers include unfavorable lipid levels and active HIV replication.
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