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10th Anniversary Conference Of The British HIV Association [BHIVA]15 – 17 April 2004, City Hall, Cardiff, UK |
[AUTHOR(S):] M Rhoads1, CJ Smith2, G Tudor-Williams1, P Kyd3, S Walters1, C Sabin2, EGH Lyall3
1 Imperial College London, 2 Royal Free and University College London, 3 St Mary's Hospital, London, UK
BHIVA Conf 2004 Apr 15-17;10:O5
BACKGROUND: As treated children with HIV survive into adulthood, potential long-term metabolic effects of CART must be considered.
METHODS: A retrospective longitudinal study of metabolites in children, before and on CART (2000–2003). Non-fasting analyses included cholesterols [total cholesterol (C), high-density lipoprotein (HDL), lowdensity lipoprotein (LDL)], triglycerides (TG), lactate (L) and glucose (G). Analysis by mixed-effects regression models [Statistical Analysis Systems (SAS) software].
RESULTS: 146 children (53% female, 68% African), aged 0.1-16 years (median 6.9), attended 1208 clinic visits. At baseline, 51% were on CART, with higher median total C, HDL and LDL, by 0.7, 0.21 and 0.43 mmol/l, respectively (P ≤0.0003). During a follow-up on CART, in mixed-effects regression, total C increased by 0.07 mmol/l per year of therapy (P=0.0001), and 53 patients (46.1%) had at least one high total C (>5 mmol/l) on treatment. L, TG and G remained stable over time on treatment, but L declined with increased age (P=0.0001). Africans had lower total C, TG, LDL and total C/HDL ratio than Caucasians.
CONCLUSION: In children, CART raises cholesterol above basal levels and this increases over time. Both HIV and CART may increase cardiovascular risk; thus on-going monitoring of lipids in children and adolescents is important. However, lactate need only be measured in those with symptoms.
PRESENTING AUTHOR: EGH Lyall
040415
O5
Copyright © 2004 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD