Early Structural and Functional Changes of the Vasculature in HIV-Infected Children

Charakida, Marietta; Donald, Ann; Green, Hannah; Storry, Clare; Clapson, Margaret; Caslake, Muriel; Dunn, David; Halcox, Julian; Gibb, Diana M; Klein, Nigel; Deanfield, John

doi:10.1161/circulationaha.104.517144

Cited by 158 publications

(137 citation statements)

References 24 publications

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“…In particular, vascular abnormalities were more pronounced in children exposed to PI therapy. These findings support a role for both HIV infection itself and ARV, above all PIs, in the pathogenesis of early vascular disease, especially in atherosclerosis [37].…”

Section: Vascular Dysfunction In Hiv-infected Childrensupporting

confidence: 68%

What happens to children growing up with HIV infection? It’s time for a HAART to heart

Viganò

Pattarino

Cerini

et al. 2009

Expert Review of Anti-infective Therapy

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Section: Vascular Dysfunction In Hiv-infected Childrensupporting

confidence: 68%

What happens to children growing up with HIV infection? It’s time for a HAART to heart

Viganò

Pattarino

Cerini

et al. 2009

Expert Review of Anti-infective Therapy

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“…Comparisons of different treatment exposure groups revealed that endothelial function was impaired by a mean of 3.6% (95% CI, 1.8 to 5.3; p<0.001) for children exposed to PIs compared with untreated children and by a mean of 1.8% (95% CI, 0.01 to 3.5; p=0.05) compared with non-PI-treated patients. This study demonstrates that structural and functional changes of the vasculature are already present during childhood in HIVinfected children and these changes were most pronounced in children receiving protease inhibitors, but were also observed in non-protease inhibitors treated and untreated children and the findings of the study support a role for both HIV infection itself and ART, particularly protease inhibitors, in the pathogenesis of early vascular disease, likely to be relevant to future clinical atherosclerosis [101]. Stein et al, recently, presented preliminary data from a prospective, randomized, multicenter substudy (A5152s) to evaluate the effects of antiretroviral therapy on endothelial function in treatment-naïve HIV infected individuals.…”

Section: Clinical Assessment Of Endothelium In Hiv Infectionsupporting

confidence: 53%

“…In order to determine the impact of HIV infection and antiretroviral therapy on markers of early vascular disease in children, Charakida et al [101] studied 83 HIV-infected children (56 had taken HAART, of whom 31 received a regimen containing protease inhibitors; 27 were never treated and a control group of 59 healthy children). Carotid intima-media thickness (IMT) and endothelial function were measured by brachial artery flow-mediated dilatation (FMD).…”

Section: Clinical Assessment Of Endothelium In Hiv Infectionmentioning

confidence: 99%

Endothelial function and cardiovascular diseases in HIV infected patient

Andrade¹,

Cotter²

2006

Braz J Infect Dis

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The HIV epidemic has dramatically changed the paradigm for the development of drug therapy in the last 15 years. The goal is now not only to provide an effective reduction of plasma viremia , but also to reconstitute the immune deficiency due to the progression of the disease. Significant problems with the metabolism of sugars and lipids lead to the appearance of well-documented disorders such as insulin resistance, abnormalities in lipid metabolism and lipodystrophy in those patients on prolonged therapy with antiretrovirals. The question of whether or not HAART-associated lipid disorders contribute to the premature development of coronary artery disease is of major importance for the HIV community. Endothelial injury is associated with disease-related biochemical abnormalities that are implicated in HIV pathogenesis. The exploration of endothelial function began in the early 1980s at the start of the epidemic. The study of endothelial function in HIV infection and its modifications by HAART is an exciting new field in clinical research; in this review the available information on cardiovascular diseases associated with HIV infection and its treatment are discussed.

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“…The main risk factors involved in the development of atherosclerotic cardiovascular disease in HIV-infected patients are dyslipidemia, body fat redistribution, insulin resistance, vascular inflammation, fibrinolysis disorder and the side effects of antiretroviral therapy [36][37][38]. Their association with the traditional risk factors increases the risk of precocious atherosclerotic disease.…”

Section: Cardiovascular Manifestationsmentioning

confidence: 99%

Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus

2008

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The introduction of highly active antiretroviral therapy (HAART) for the treatment of acquired immunodeficiency syndrome (AIDS) has resulted in greater survival of patients infected with the human immunodeficiency virus (HIV). However, the use of these drugs has been associated with lipodystrophic syndrome (LS), which is characterized by metabolic alterations (dyslipidemia, insulin resistance, diabetes, and lactic acidosis) and abnormal corporal fat distribution. Clinically, LS may manifest as three different forms: lipohipertrophy (accumulation of fat in the central part of the body), lipoatrophy (loss of fat in the extremities, face and buttocks) and mixed (lipohipertrophy + lipoatrophy). Although its physiopathology has not been elucidated, some mechanisms have been described, including leptin and adiponectin deficiency, mitochondrial dysfunction and use of antiretroviral drugs. The type, dose and duration of the antiretroviral treatment, as well as age and puberty are the main risk factors. LS is also associated with increased incidence of cardiovascular illnesses, atherosclerosis and diabetes mellitus. Treatment includes physical activity, cautious restriction of caloric intake, changes in antiretroviral therapy, and use of insulin-sensitizing and lipid-lowering agents. Follow up must be periodic, consisting of measurement of body fat distribution, evaluation of the lipid profile and insulin resistance.

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Early Structural and Functional Changes of the Vasculature in HIV-Infected Children

Cited by 158 publications

References 24 publications

What happens to children growing up with HIV infection? It’s time for a HAART to heart

What happens to children growing up with HIV infection? It’s time for a HAART to heart

Endothelial function and cardiovascular diseases in HIV infected patient

Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus

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