Lipidome composition, immune activation and subclinical vascular disease in Adolescents with perinatally acquired HIV in Uganda

项目概要/摘要： 全世界有210万15岁以下的儿童感染艾滋病毒;绝大多数 在围产期感染艾滋病毒（PHIV），居住在东部和南部非洲。儿童 现在，预计PHIV感染者将度过青春期并进入成年期， 青少年现在是艾滋病毒感染者中人数最多的增长群体。几种合并症， 包括心脏代谢的，与增强的免疫激活有关， 感染艾滋病毒的成年人中，尽管病毒受到抑制，由于体积小， 由于缺乏儿科数据，关于其机制和程度存在争议， 在这个年轻的群体中，在形成年龄段，炎症加剧应该引起关注。 脂质组学分析揭示了脂质类和脂肪酸之间的关联 该组合物具有炎症和几种疾病，包括心脏代谢并发症。 该项目的总体目标是获得对PHIV及其相关因素的新见解。 免疫激活和亚临床心血管疾病。我们将使用新的公正 整合脂质组学的分析，并带来一种创新的方法来识别信号 与脂质加工相关的级联反应可预测心血管并发症 PHIV。在一项对100名PHIV和年龄性别匹配的未感染对照的纵向研究中， 该项目旨在测量超过96周的脂质组，以确定与脂质紊乱相关的 与艾滋病毒和免疫激活相关的途径。我们将调查是否亲- 炎性脂质预示亚临床血管疾病。此外，我们将研究 特定ART类别以及个体抗逆转录病毒药物对脂质体的作用。 这项拟议的研究利用了Dirajlal-Fargo博士在乌干达进行的K23研究的丰富数据。 这项研究将建立在病毒抑制的PHIV青少年的良好表型队列基础上 和年龄和性别匹配的未感染对照组，并利用储存库标本。 纵向设计将允许数据验证和复制， 先前的观察性组学研究。这项研究可能揭示了新的生物标志物签名， 预防青少年心血管疾病的生物学、临床和预后相关性 正在步入成年并接受了长期ART治疗的人。

Project Summary/Abstract: There are 2.1 million children under 15 years living with HIV worldwide; the vast majority have perinatally acquired HIV (PHIV) and reside in Eastern and Southern Africa. Children living with PHIV are now expected to live through adolescence and well into adulthood, such that adolescents now represent the largest growing population living with HIV. Several comorbidities, including cardiometabolic, have been associated with heightened immune activation and inflammation despite viral suppression in adults living with HIV. Because of the small size and paucity of pediatric data, controversy exists regarding the mechanisms and the extent to which heightened inflammation should be concerning in this young population during formative years. Lipidomics analyses have revealed associations of lipid classes and fatty acid composition with inflammation and several diseases, including cardiometabolic complications. The overall goal of this project is to obtain new insight into PHIV and the factors associated with immune activation and subclinical cardiovascular disease. We will use novel unbiased analysis of integrated lipidomic and bring an innovative approach to identify signaling cascades related to lipid processing that may predict cardiovascular complications in PHIV. In a longitudinal study of 100 PHIV and age-and sex-matched uninfected controls, this project aims to measure the lipidome over 96 weeks to identify lipid perturbations associated with HIV and pathways associated with immune activation. We will investigate whether pro- inflammatory lipids are predictive of subclinical vascular disease. Additionally, we will examine the role of specific ART classes as well as individual antiretroviral drugs on the lipidome. The proposed study leverages the rich data of Dr. Dirajlal-Fargo’s K23 study in Uganda. This study will build on the well-phenotyped cohort of virally suppressed adolescents with PHIV and age-and sex- matched uninfected comparison group and utilize repository specimens. The longitudinal design will allow for data validation and replication, a major criticism of prior observational omics studies. This study may reveal novel biomarker signatures of biological, clinical, and prognostic relevance to prevent cardiovascular disease for adolescents who are advancing into adulthood and have received long-term ART.