High Rate of Coronary Artery Abnormalities in Adolescents and Young Adults Infected With Human Immunodeficiency Virus Early in Life

Mikhail, Irene; Purdy, Julia B.; Dimock, David; Thomas, V.; Muldoon, Nancy; Clauss, Sarah; Cross, Russell R.; Pettigrew, Roderic I.; Hazra, Rohan; Hadigan, Colleen; Gharib, Ahmed M.

doi:10.1097/inf.0b013e31820f6575

Cited by 29 publications

(13 citation statements)

References 12 publications

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“…22–24 The risk factors included in the CA and AA scores are also associated with non-invasive measures of atherosclerosis among HIV-infected children. 25,26 Thus, as a validated measure of the atherosclerotic disease process, we utilized PDAY scores to describe CVD risk in perinatally HIV-infected adolescents enrolled in the Pediatric HIV/AIDS Cohort Study. We additionally identified demographic and HIV-specific predictors of high scores and evaluated trends in scores over the 4-year study follow-up period.…”

Section: Introductionmentioning

confidence: 99%

Aggregate Risk of Cardiovascular Disease Among Adolescents Perinatally Infected With the Human Immunodeficiency Virus

et al. 2014

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Background Perinatally HIV-infected adolescents may be susceptible to aggregate atherosclerotic cardiovascular disease (CVD) risk, as measured by the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) coronary arteries (CA) and abdominal aorta (AA) risk scores, due to prolonged exposure to HIV and antiretroviral therapy. Methods and Results CA and AA PDAY scores were calculated for 165 perinatally HIV-infected adolescents, using a weighted combination of modifiable risk factors: dyslipidemia, cigarette smoking, hypertension, obesity, and hyperglycemia. Demographic and HIV-specific predictors of scores ≥ 1 were identified and trends in scores over time were assessed. 48% and 24% of the perinatally HIV-infected adolescents had CA and AA scores ≥ 1, representing increased CVD risk factor burden. Significant predictors of CA scores ≥ 1 included male sex, history of an AIDS-defining condition, longer duration of use of a ritonavir-boosted protease inhibitor, and no prior use of tenofovir. Significant predictors of AA scores ≥ 1 included suppressed viral load, history of an AIDS-defining condition, and longer duration of boosted protease inhibitor use. No significant changes in CA and AA risk scores were observed over the 4-year study period. Conclusions A substantial proportion of perinatally HIV-infected youth have high PDAY scores reflecting increased aggregate atherosclerotic CVD risk factor burden. High scores were predicted by HIV disease severity and boosted protease inhibitor use. PDAY scores may be useful in identifying high-risk youth who may benefit from early lifestyle or clinical interventions.

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Section: Introductionmentioning

confidence: 99%

Aggregate Risk of Cardiovascular Disease Among Adolescents Perinatally Infected With the Human Immunodeficiency Virus

et al. 2014

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“…More than half (14/27) of the subjects had evidence of coronary artery abnormalities with luminal narrowing detected on MR angiography; 13 classified as level 2 narrowing and 1 classified as level 3. Although the study is small and did not have a control population for comparison, this study indicates that children and young adults infected with HIV in early life may have a high rate of early atherosclerotic coronary lesions as detected by MRI [13].…”

Section: Atherosclerosismentioning

confidence: 96%

Cardiovascular Complications in Children with HIV Infection

Sims

Hadigan

2011

Curr HIV/AIDS Rep

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Before effective antiretroviral treatment was introduced in children with HIV, cardiovascular complications were a major cause of morbidity and mortality. Now that antiretroviral treatment is the standard of care in this population, there has been a shift from fulminant cardiovascular complications to recognition of cardiovascular issues related to HIV as a chronic disease state and its treatment. This review explores the recent advances in understanding the roles of atherosclerosis, inflammation, biomarkers, and metabolic abnormalities in cardiac function and cardiovascular disease risk in children with HIV. The true risk and prevalence of cardiovascular outcomes in HIV-infected children and adolescents has yet to be realized. Recently, however, investigators are exploring new cardiovascular health challenges that face children living with HIV, and developing strategies to lower the cardiovascular disease risk for these children.

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“…(93–96) A recent report of high rates of coronary artery abnormalities on cardiac magnetic resonance imaging (MRI) in adolescents and young adults with a long standing history of HIV exposure suggested possible early atherosclerosis in this population. (97) Although not associated with coronary artery disease in adults, coronary irregularities were seen in youth with increased cumulative exposure to tenofovir disoproxil fumarate (TDF) and 3TC. (97) Based on the potential risks of long-term associated ART toxicity and delayed onset in their clinical presentations, accumulation of new data and development of the biomarkers to facilitate early identification of children at high risk for ARV associated toxicities are urgently needed.…”

Section: Treatment Of Hiv In Adolescentsmentioning

confidence: 99%

“…(97) Although not associated with coronary artery disease in adults, coronary irregularities were seen in youth with increased cumulative exposure to tenofovir disoproxil fumarate (TDF) and 3TC. (97) Based on the potential risks of long-term associated ART toxicity and delayed onset in their clinical presentations, accumulation of new data and development of the biomarkers to facilitate early identification of children at high risk for ARV associated toxicities are urgently needed.…”

Section: Treatment Of Hiv In Adolescentsmentioning

confidence: 99%

Pharmacotherapy of Pediatric HIV Infection

Rakhmanina

Phelps

2012

Pediatric Clinics of North America

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SYNOPSIS With the ongoing epidemic of human immune deficiency virus (HIV) infections in the pediatric age group, the delivery of safe and effective antiretroviral therapy to children and adolescents is crucial to save the lives of millions of children worldwide. Antiretroviral drugs have been demonstrated to significantly decrease HIV-associated morbidity and mortality, assure normal growth and development, and improve survival and quality of life in children and adolescents. The immunologic response to HIV infection is closely related to the child’s development and creates age specific parameters for the evaluation of therapeutic response to antiretroviral therapy in pediatric HIV disease. In addition to the changes in immunological response to HIV infection, the development and maturation of organ systems involved in drug absorption, distribution, metabolism, and elimination determines significant changes in the pharmacokinetics of antiretroviral drugs throughout the childhood. Multiple factors including age-specific adherence barriers, changes in social and economical surroundings, and psychological and sexual maturation affect the choices and outcomes of the treatment of pediatric HIV disease. In this chapter we will review the evolution of antiretroviral treatment from early infancy through adolescence.

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High Rate of Coronary Artery Abnormalities in Adolescents and Young Adults Infected With Human Immunodeficiency Virus Early in Life

Cited by 29 publications

References 12 publications

Aggregate Risk of Cardiovascular Disease Among Adolescents Perinatally Infected With the Human Immunodeficiency Virus

Aggregate Risk of Cardiovascular Disease Among Adolescents Perinatally Infected With the Human Immunodeficiency Virus

Cardiovascular Complications in Children with HIV Infection

Pharmacotherapy of Pediatric HIV Infection

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