Association of hypercholesterolemia incidence with antiretroviral treatment, including protease inhibitors, among perinatally HIV-infected children.
Association of hypercholesterolemia incidence with antiretroviral treatment, including protease inhibitors, among perinatally HIV-infected children.
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围产期艾滋病毒感染儿童中高胆固醇血症发生率与抗逆转录病毒治疗（包括蛋白酶抑制剂）的关系。
DOI：
10.1097/qai.0b013e3181648e16
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发表时间：
2008
期刊：
影响因子：
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通讯作者：
InternationalMaternalPediatricAdolescentAIDSClinicalTrials219CTeam
中科院分区：
文献类型：
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作者：
Tassiopoulos,Katherine;Williams,PaigeL;Seage3rd,GeorgeR;Crain,Marilyn;Oleske,James;Farley,John;InternationalMaternalPediatricAdolescentAIDSClinicalTrials219CTeam
目的：评价一项大型儿科研究中高胆固醇血症的发生率和危险因素，设计：前瞻性队列研究（儿科艾滋病临床试验组219 C），参与者：共2122例围产期HIV感染儿童，入组时无高胆固醇血症，结果：发生高胆固醇血症（连续2次访视时总胆固醇≥ 220 mg/dL）。考克斯比例风险模型被用来评估risk factors.Results：13%的儿童有高胆固醇血症在进入，和额外的13%发展高胆固醇血症在随访期间的发病率为3.4例每100人年（95%置信区间[CI]：3.0至3.9）。调整年龄后，增加蛋白酶抑制剂（PI）的使用（风险比[HR]= 13.9，95% CI：6.73 - 28.6），使用非加强PI（HR= 8.65，95% CI：4.19 - 17.9）和非核苷类逆转录酶抑制剂使用（HR= 1.33，95% CI：1.04至1.71）与高胆固醇血症风险增加相关，较高的病毒载量具有保护作用（> 50，000 vs. ≤ 400拷贝/mL; HR= 0.59，95% CI：0.39至0.90）。自我报告的遵守科目有较高的risk.Conclusions：PI是高胆固醇血症的重要危险因素。较高的病毒载量具有保护作用，可能反映了不依从性。进一步随访对于评价长期PI暴露和高胆固醇血症的长期后果至关重要。
Objective:To evaluate the incidence of and risk factors for development of hypercholesterolemia in a large pediatric study.Design:Prospective cohort study (Pediatric AIDS Clinical Trials Group 219C).Participants:A total of 2122 perinatally HIV-infected children free of hypercholesterolemia at entry.Outcome:Development of hypercholesterolemia (total cholesterol≥ 220 mg/dL at 2 consecutive visits). Cox proportional hazards models were used to evaluate risk factors.Results:Thirteen percent of children had hypercholesterolemia at entry, and an additional 13% developed hypercholesterolemia during follow-up for an incidence rate of 3.4 cases per 100 person-years (95% confidence interval [CI]: 3.0 to 3.9). After adjustment for age, boosted protease inhibitor (PI) use (hazard ratio [HR]= 13.9, 95% CI: 6.73 to 28.6), nonboosted PI use (HR= 8.65, 95% CI: 4.19 to 17.9), and nonnucleoside reverse transcriptase inhibitor use (HR= 1.33, 95% CI: 1.04 to 1.71) were associated with increased risk of hypercholesterolemia, and higher viral load was protective (> 50,000 vs.≤ 400 copies/mL; HR= 0.59, 95% CI: 0.39 to 0.90). Self-reported adherent subjects had higher risk.Conclusions:PIs were significant risk factors for hypercholesterolemia. Higher viral load was protective and may reflect nonadherence. Further follow-up is critical to evaluate long-term consequences of chronic PI exposure and hypercholesterolemia.