Echocardiography and carotid intima-media thickness among asymptomatic HIV-infected adolescents in Thailand.

Abstract

OBJECTIVES:

To evaluate the carotid intima-media thickness (cIMT) in perinatally HIV-infected adolescents and factors associated with cardiovascular abnormalities.

DESIGNS:

A cross-sectional study was conducted in perinatally HIV-infected adolescents who had no known cardiovascular condition and healthy controls.

METHODS:

Transthoracic echocardiogram and cIMT measurements were taken by pediatric cardiologists. Serum lipid profiles, high-sensitivity C-reactive protein and N-terminal pro-brain natriuretic peptide were measured.

RESULTS:

Hundred HIV-infected and 50 healthy adolescents were enrolled. Echocardiograms revealed overall normal systolic function (median left-ventricular ejection fraction 66 vs. 66%; P = 0.825). The mean overall cIMTs of common carotid arteries and internal carotid arteries were not different between the groups (0.373 vs. 0.371; P = 0.744). Among the HIV-infected adolescents, those who had been receiving protease inhibitor-containing regimens had an increased cIMT (0.364 vs. 0.381 mm; P = 0.009). Hypertriglyceridemia was found in 52% of those who had received protease inhibitors for more than 6 months, but only in 21% of those who had never received protease inhibitors (odds ratio 4.0, 95% confidence interval 1.6-9.7, P = 0.002). Current HIV-RNA, CD4, BMI, sex, cholesterol and low-density lipoprotein-cholesterol were not associated with increased cIMT. Serum high-sensitivity C-reactive protein and N-terminal pro-brain natriuretic peptide were not different between the groups and not associated with cardiac abnormalities.

CONCLUSIONS:

Perinatally HIV-infected adolescents had comparable myocardial function and similar cIMT measurements to healthy adolescents. However, hypertriglyceridemia and increased cIMT were found in HIV-infected adolescents receiving protease inhibitor-based regimens. Longer-term follow-up is needed to evaluate HIV-associated cardiovascular disease risk in this population.

• Authors: Prakul Chanthong, Keswadee Lapphra, Supawan Saihongthong, Sirintip Sricharoenchai, Orasri Wittawatmongkol, Wanatpreeya Phongsamart, Supattra Rungmaitree, Nantaka Kongstan, Kulkanya Chokephaibulkit
• Journal: AIDS (London, England) (AIDS) Vol. 28 Issue 14 Pg. 2071-9 (Sep 10 2014) ISSN: 1473-5571 [Electronic] England
• PMID: 25265075 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Lipids
• Peptide Fragments
• Triglycerides
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain
• C-Reactive Protein

Topics

• Adolescent
• Antiretroviral Therapy, Highly Active
• C-Reactive Protein (metabolism)
• Carotid Intima-Media Thickness
• Child
• Cross-Sectional Studies
• Echocardiography
• Female
• HIV Infections (blood, pathology)
• Humans
• Lipids (blood)
• Male
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Prospective Studies
• Risk Factors
• Thailand (epidemiology)
• Triglycerides (blood)
• Young Adult