Increased carotid intima media thickness (IMT) and cardiac biomarkers in HIV-infected children indicate that they are more likely than their uninfected counterparts to develop cardiovascular problems.
As in adults, lead investigator Dr. Grace A. McComsey told Reuters Health, "chronic HIV infection in kids is associated with enhanced risk of heart disease."
"All children in this study were treated with antiretrovirals," she added, "so we were unable to conclude whether the findings reflect the effect of HIV itself or the treatment."
As reported in the May 11th issue of AIDS, Dr. McComsey of Case Western Reserve University, Cleveland, Ohio and colleagues studied 31 children with HIV and a like number without the disease.
The HIV children had higher waist-to-hip ratio, higher cholesterol, triglycerides, and myeloperoxidase levels, and lower homocysteine levels. They also had significantly higher internal carotid artery and common carotid artery IMT.
Body mass index and homocysteine levels were significant predictors of IMT in uninfected children, but in the HIV group the only predictor was the length of antiretroviral therapy.
"These children," continued Dr. McComsey, "will likely remain on treatment for decades and pediatricians should be concerned and watchful for premature atherosclerosis. The best current approach would be for pediatricians to closely monitor and work to prevent known risk factors for heart disease such as obesity, smoking, high lipid levels, and diabetes"
Moreover, she concluded, "we should take very seriously the issue of high lipids and insulin resistance in kids with HIV. Obesity, a common problem in US children, is prevalent in kids with HIV and may add to the risk of heart disease."
AIDS 2007;21:921-927.
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