HIV and cART-Associated Dyslipidemia among HIV-Infected Children

HIV and cART-Associated Dyslipidemia among HIV-Infected Children

By: Birkneh Tilahun Tadesse, Byron Alexander Foster, Adugna Chala, Tolossa Eticha Chaka, Temesgen Bizuayehu, Freshwork Ayalew, Getahun H/Meskel, Sintayehu Tadesse, Degu Jerene, Eyasu Makonnen, Eleni Aklillu
Publication: Journal of Clinical Medicine2019; Vol. 8: 430. DOI: 10.3390/jcm8040430.

Abstract

Background

Persistent dyslipidemia in children is associated with risks of cardiovascular accidents and poor combination antiretroviral therapy (cART) outcome. We report on the first evaluation of prevalence and associations with dyslipidemia due to HIV and cART among HIV-infected Ethiopian children.

Methods

105 cART naïve and 215 treatment experienced HIV-infected children were enrolled from nine HIV centers. Demographic and clinical data, lipid profile, cART type, adherence to and duration on cART were recorded. Total, low density (LDLc) and high density (HDLc) cholesterol values >200 mg/dL, >130 mg/dL, <40 mg/dL, respectively; and/or, triglyceride values >150 mg/dL defined cases of dyslipidemia. Prevalence and predictors of dyslipidemia were compared between the two groups.

Results

Prevalence of dyslipidemia was significantly higher among cART experienced (70.2%) than treatment naïve (58.1%) children (p = 0.03). Prevalence of low HDLc (40.2% versus 23.4%, p = 0.006) and hypertriglyceridemia (47.2% versus 35.8%, p = 0.02) was higher among cART experienced than naïve children. There was no difference in total hypercholesterolemia and high LDLc levels. Nutrition state was associated with dyslipidemia among cART naïve children (p = 0.01).

Conclusion

High prevalence of cART-associated dyslipidemia, particularly low HDLc and hypertriglyceridemia, was observed among treatment experienced HIV-infected children. The findings underscore the need for regular follow up of children on cART for lipid abnormalities.