Cardiovascular Risk Factors Associated with Atherosclerosis in Children who are HIV-seropositive

  • Dr Tracie Miller, University of Miami Miller School of Medicine, United States
  • John Orav, Harvard School of Public Health, United States
  • Gabriel Somarriba, University of Miami Miller School of Medicine, United States
  • Daniella Neri, University of Miami Miller School of Medicine
  • Natasha Schaefer, University of Miami Miller School of Medicine, United States
  • Armando Mendez, University of Miami Miller School of Medicine, United States
  • Lawrence Friedman, University of Miami Miller School of Medicine, United States
  • Gwendolyn Scott, University of Miami Miller School of Medicine, United States

    • Objective: HIV+ children have cardiovascular risk factors associated with atherosclerosis. We compared biomarkers of vascular dysfunction among HIV+ children to a similar group of HIV- children and determined factors associated with these biomarkers.

    Methods: Biomarkers of vascular dysfunction (inflammation; hsCPR, IL-6. MCP1: coagulant dysfunction; fibrinogen, P-selectin: endothelial dysfunction; sICAM, vICAM, E-selectin: and metabolic dysfunction; leptin) were measured in HIV+ and HIV- children. We simultaneously measured height, weight, waist and hip circumference, body fat, CD4%, HIV viral load, and antiretroviral therapy.

    Results: 105 HIV+ (age 14.8y; SD4.3) and 55 HIV- (age 12.3y; SD3.8) children were evaluated. Sex and BMI z-scores (.51 both groups) were similar. sICAM (240 vs 185); vICAM (1141 vs 685); MCP1 (154 vs 106); IL-6 (1.26 vs 0.88); and fibrinogen (376 vs 324) were all significantly elevated in the HIV+ group. E-selectin (p=0.07), and CRP (p=0.08) trended to be greater yet leptin, and P-selectin were similar. The HIV+ children were on HAART for a mean of 6y (SD=3.1). In multivariable analyses, a 1 SD increase in waist/hip ratio was significantly related to a 17% increase in sICAM (p=0.01), a 19% increase in MCP1 (p<0.001), an 18% increase in IL6 (p=0.04) and a 59% increase in CRP (p=0.01). Low CD4% was independently associated with higher levels of biomarkers (vICAM 12%; p=0.03: MCP1 18%; p<0.001: IL6 22%; p=0.004: fibrinogen 5%; p=0.03: CRP 34%; p=0.02).

    Conclusion: HIV+ children have higher levels of atherosclerotic biomarkers compared to sociodemographically-similar HIV- children. Measures associated with biomarkers include waist/hip ratios and HIV disease severity.