AIDS hypercholesterolemia affects 13% of children with HIV
The prevalence of hypercholesterolemia was 13% in children infected with the AIDS virus (HIV) seems to be significantly associated with protease inhibitors, according to a study published in the journal "JAIDS".
Perinatal exposure to HIV affects cholesterol
The team of John Farley followed 1,999 children aged 4 to 19 years of HIV + and having suffered perinatal exposure to the virus, including 1812 were eventually infected.
Among HIV + children, 13% (229) had hypercholesterolemia according to the criteria of the NHANES III using standard for age, sex and ethnicity, compared to 9% of HIV-children.
Similarly, 22% of HIV + had a cholesterol level greater than 2 g / l against 9% and 12% HIV-cholesterol levels greater than 2 g / l against 4% of HIV.
The cholesterol associated with low viral load
A low viral load as a high CD4 count were significantly associated with high cholesterol.
Children who have normal cholesterol levels have higher viral loads (2164 copies / ml) than children with hypercholesterolemia (mean viral load below 400 copies / ml).
Children with a viral load less than 400 copies / ml and present, in this cohort, a three times higher risk of developing high cholesterol.
Each increase of one log 10 RNA corresponds to a decrease in the risk of high cholesterol by 50% and each increase of 100 cells / ml or 10% of CD4 increases the risk of 7% and 21% respectively.
Hypercholesterolemia associated with protease inhibitors
Treatment with protease inhibitors (PIs) is significantly associated with high cholesterol, unlike treatment with nucleoside reverse transcriptase inhibitors (IN). The prevalence of hypercholesterolemia and five times higher in the IP + over-IP (17% vs 3%).
As for non-nucleoside inhibitors (INN), if the prevalence of hypercholesterolemia is greater (16% vs. 11%), it seems, once again, due to the associated IP use.
It is in fact only 2% for INN-/IP- treatments, 6% for INN + / IP, 15% for INN-/IP + and 20% for + / IP + INN. It also increases with the number of IP included in the treatment (20% with at least 2 IP) but instead the duration of treatment did not affect the prevalence.
Finally, adherence to HAART increases the risk of high cholesterol. "Children who have reached the goal virological have the highest prevalence of hypercholesterolemia (24%)," the authors write, which, according to them, the need for careful monitoring lipid.
The youngest, the most affected
In addition, a link appears with the young, which "suggests that neither viremia nor the age of the HIV infection are independent risk factors for high cholesterol," they add.
However, "although it is reassuring to know that high cholesterol is not associated with other cardiovascular risk factors such as obesity or hypertension in children infected with HIV, it is quite alarming to note that are younger patients with a longer duration of exposure, which are most likely to develop high cholesterol, "the authors note.
"The risk of high cholesterol should be considered in the choice of initial antiretroviral therapy, monitoring of lipid is clearly indicated in children infected perinatally treated with IP," they conclude.
Perinatal exposure to HIV affects cholesterol
The team of John Farley followed 1,999 children aged 4 to 19 years of HIV + and having suffered perinatal exposure to the virus, including 1812 were eventually infected.
Among HIV + children, 13% (229) had hypercholesterolemia according to the criteria of the NHANES III using standard for age, sex and ethnicity, compared to 9% of HIV-children.
Similarly, 22% of HIV + had a cholesterol level greater than 2 g / l against 9% and 12% HIV-cholesterol levels greater than 2 g / l against 4% of HIV.
The cholesterol associated with low viral load
A low viral load as a high CD4 count were significantly associated with high cholesterol.
Children who have normal cholesterol levels have higher viral loads (2164 copies / ml) than children with hypercholesterolemia (mean viral load below 400 copies / ml).
Children with a viral load less than 400 copies / ml and present, in this cohort, a three times higher risk of developing high cholesterol.
Each increase of one log 10 RNA corresponds to a decrease in the risk of high cholesterol by 50% and each increase of 100 cells / ml or 10% of CD4 increases the risk of 7% and 21% respectively.
Hypercholesterolemia associated with protease inhibitors
Treatment with protease inhibitors (PIs) is significantly associated with high cholesterol, unlike treatment with nucleoside reverse transcriptase inhibitors (IN). The prevalence of hypercholesterolemia and five times higher in the IP + over-IP (17% vs 3%).
As for non-nucleoside inhibitors (INN), if the prevalence of hypercholesterolemia is greater (16% vs. 11%), it seems, once again, due to the associated IP use.
It is in fact only 2% for INN-/IP- treatments, 6% for INN + / IP, 15% for INN-/IP + and 20% for + / IP + INN. It also increases with the number of IP included in the treatment (20% with at least 2 IP) but instead the duration of treatment did not affect the prevalence.
Finally, adherence to HAART increases the risk of high cholesterol. "Children who have reached the goal virological have the highest prevalence of hypercholesterolemia (24%)," the authors write, which, according to them, the need for careful monitoring lipid.
The youngest, the most affected
In addition, a link appears with the young, which "suggests that neither viremia nor the age of the HIV infection are independent risk factors for high cholesterol," they add.
However, "although it is reassuring to know that high cholesterol is not associated with other cardiovascular risk factors such as obesity or hypertension in children infected with HIV, it is quite alarming to note that are younger patients with a longer duration of exposure, which are most likely to develop high cholesterol, "the authors note.
"The risk of high cholesterol should be considered in the choice of initial antiretroviral therapy, monitoring of lipid is clearly indicated in children infected perinatally treated with IP," they conclude.
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