Dyslipidemia in Children With HIV Started on Antiretroviral Therapy
Lipid panel, plasma viral load, and CD4 cell counts were obtained at baseline, 6 months, and 12 months.
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SAN DIEGO — Serum lipid profile changes were shown to occur within the first year of initiating antiretroviral therapy in children, with a greater increase in high-density cholesterol relative to low-density cholesterol and triglycerides, according to a study presented at IDWeek.
In this prospective study, researchers recruited 393 children with HIV initiating first-line antiretroviral therapy for the first time (2-12 years of age; 66% zidovudine- and 14% stavudine-based regimens). Baseline, 6-month, and 12-month measurements of lipid profiles, plasma viral load, and CD4 T-cell counts were obtained.
Compared with baseline, researchers reported increases in total cholesterol (mean, 31 mg/dL), low-density cholesterol (13.7 mg/dL), and high-density cholesterol (19 mg/dL; all P <.000). Moreover, the mean total cholesterol/high-density cholesterol ratio decreased from 5.1 at baseline to 3.5 at 12-month follow-up (P <.001).
After 12 months of treatment, the rates of total cholesterol >200 mg/dL (3% vs 13%), low-density cholesterol >130 mg/dL (5% vs 8%), high-density cholesterol <35 mg/dL (70% vs 16%), and triglycerides >150 mg/dL (38% vs 24%) were all changed.
HIV viral load >400 copies/mL at baseline was associated with higher high-density cholesterol and lower triglyceride levels after 1 year of treatment. Similarly, baseline CD4% <15 and younger age were associated with an increase in total cholesterol and decrease in triglycerides.
The researchers concluded that "significant changes in serum lipid profile occurs early in children started on first-line [antiretroviral therapy].... Regular monitoring of lipid levels will help in early identification of metabolic complications of [antiretroviral therapy]."
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Perumal Kannabiran B, Padmapriyadarsini C, Sanjeeva GN, et al. Dyslipidaemia among children living with HIV after 48 weeks of first-line antiretroviral therapy. Presented at: IDWeek 2017; October 4-8, 2017; San Diego, CA. Poster 577.