Cardiac Toxicity in Perinatally HIV-infected Adolescents and Young Adults, a Longitudinal Study

项目摘要 虽然高效抗逆转录病毒疗法的广泛使用显著降低了心脏病发病率， 围产期HIV感染儿童的死亡率，一些研究表明， 超声心动图测量左心室结构和功能。这项研究的目的是纵向 评估围产期HIV感染青少年和年轻人的心血管状况， 慢性炎症和/或线粒体异常是否与超声心动图和 生物标志物随时间变化。本研究的具体目的是：1）确定 6年前在AMP（青少年）和AMP Up（青年）中评估的心血管危险因素 儿童HIV/AIDS的围产期HIV感染（PHIV）和HIV暴露、未感染（HEU）队列 队列研究（PHACS），并测量青年或青少年动脉粥样硬化的改良病理生物学决定因素， 艾滋病毒感染青少年的PDAY评分（心血管综合风险的衡量标准）; 2） 评价全身线粒体功能在心血管指标异常中的作用， 通过测定线粒体耗氧量（呼吸）和氧化应激来检测生物标志物。的结果 这项研究可以确定是否有围产期艾滋病毒感染的青少年和年轻人， 暴露于HAART，这是在未来心血管疾病的风险增加。如果是这种情况， 这项研究的结果可以为这种心血管风险增加的人群提供各种干预措施， 他们未来发生心血管不良事件的风险。

Project Summary While the widespread use of highly active antiretroviral therapy has markedly decreased cardiac morbidity and mortality in perinatally HIV-infected children, several studies have suggested subclinical abnormalities in echocardiographic measures of left ventricular structure and function. The goal of this study is to longitudinally evaluate the cardiovascular status of perinatally HIV-infected adolescents and young adults and to explore whether chronic inflammation and/or mitochondrial abnormalities are associated with echocardiographic and biomarker changes over time. The specific aims of this study are to 1) to determine longitudinal changes of cardiovascular risk factors that were assessed ~6 years ago in the AMP (adolescents) and AMP Up (young adults) perinatally HIV-infected (PHIV) and HIV-exposed, uninfected (HEU) cohorts of the Pediatric HIV/AIDS Cohort Study (PHACS) and to measure modified Pathobiological Determinants of Atherosclerosis in Youth or PDAY scores (a measure of aggregate cardiovascular risk) in HIV-infected adolescents longitudinally; and 2) to evaluate the role of systemic mitochondrial function in abnormalities of cardiovascular measures and biomarkers by assaying for mitochondrial oxygen consumption (respiration) and oxidative stress. The results of this study can identify if there are perinatally HIV-infected adolescents and young adults, with long term exposure to HAART, which are at increased risk of future cardiovascular morbidities. If this is the case, the results of this study can inform various interventions in this increased cardiovascular risk group to decrease their future risk of adverse cardiovascular events.