Youth with HIV at increased risk for atherosclerosis

New data from a multicenter study show that the risk for atherosclerosis appears to be 2.5-fold higher in children and adolescents with HIV, researchers reported at EUROECHO and other Imaging Modalities 2012 in Athens, Greece.

Highly active antiretroviral therapy (HAART) prolongs the lives of patients with HIV, but the drugs increase LDL and lower HDL cholesterol. Additionally, HAART is not a cure, and the virus remains in the body.

“This is especially important for children because they have been living with HIV since birth or even before. By the time they are 50 years old, they will have accumulated more toxicity from the treatment and more secondary effects from the infection and will be at an even greater risk of heart attacks and other complications,” said principal investigator Talia Sainz Costa, MD, from the University General Hospital Gregorio Maranon, Madrid, Spain, in a press release.

Talia Sainz Costa

Researchers measured carotid intima-media thickness (IMT) in 150 children and young adults with HIV and 150 age- and sex-matched controls (mean age, 14.6 years; 63% girls). Seventeen percent of the patients with HIV were smokers, as compared with 11% in the control group. Nearly 97% of the group with HIV had an undetectable viral load; all but four patients were on HAART. IMT was thicker in patients with vs. without HIV (0.434 vs. 0.424; P=.018). After adjustment for age, sex, BMI and smoking status, HIV was independently associated with thicker IMT (OR=2.68; 95% CI, 1.34-5.35), according to the abstract.

Activated T CD4+ cells were higher among children and young adults with HIV (P=.002) and borderline statistically significant for activated CD8+ cells (P=.087) and senescent T CD4+ and T CD8 cells. Treated and viremic patients had the highest frequency of CD4+ and CD8+ activation and senescence compared with controls and patients with undetectable viral loads (P<.05).

"Our study shows that children and adolescents with HIV have arteries that are more rigid and less elastic, which means that the process of atherosclerosis has begun and they have increased risk of infarct in the future," said Costa in the release. "In the meantime, clinicians need to focus on ensuring their young patients with HIV take the antiretroviral treatment, take lipid-lowering drugs when necessary and adopt healthier lifestyles."

For more information:

Sainz Costa T. #P1020. Presented at: EUROECHO 2012; Dec. 5-8, 2012; Athens, Greece.

Sainz Costa T. Euro J Echocardiography Abstracts Supplement (2012) 13 (S1) i178.

Disclosure:The researchers report no relevant financial disclosures.