Aggregate risk of cardiovascular disease among adolescents perinatally infected with the human immunodeficiency virus

Kunjal Patel*, Jiajia Wang, Denise L. Jacobson, Steven E. Lipshultz, David C. Landy, Mitchell E. Geffner, Linda A. DiMeglio, George R. Seage, Paige L. Williams, Russell B. Van Dyke, George K. Siberry, William T. Shearer, Luciana Young, Gwendolyn B. Scott, James D. Wilkinson, Stacy D. Fisher, Thomas J. Starc, Tracie L. Miller

*Corresponding author for this work

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background: Perinatally HIV-infected adolescents may be susceptible to aggregate atherosclerotic cardiovascular disease risk, as measured by the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) coronary arteries and abdominal aorta risk scores, as a result of prolonged exposure to HIV and antiretroviral therapy. Methods and Results: Coronary arteries and abdominal aorta PDAY scores were calculated for 165 perinatally HIV-infected adolescents, using a weighted combination of modifiable risk factors: dyslipidemia, cigarette smoking, hypertension, obesity, and hyperglycemia. Demographic and HIV-specific predictors of scores ≥1 were identified, and trends in scores over time were assessed. Forty-eight percent and 24% of the perinatally HIV-infected adolescents had coronary arteries and abdominal aorta scores ≥1, representing increased cardiovascular disease risk factor burden. Significant predictors of coronary arteries scores ≥1 included male sex, history of an AIDS-defining condition, longer duration of use of a ritonavir-boosted protease inhibitor, and no prior use of tenofovir. Significant predictors of abdominal aorta scores ≥1 included suppressed viral load, history of an AIDS-defining condition, and longer duration of boosted protease inhibitor use. No significant changes in coronary arteries and abdominal aorta risk scores were observed over the 4-year study period. Conclusions: A substantial proportion of perinatally HIV-infected youth have high PDAY scores, reflecting increased aggregate atherosclerotic cardiovascular disease risk factor burden. High scores were predicted by HIV disease severity and boosted protease inhibitor use. PDAY scores may be useful in identifying high-risk youth who may benefit from early lifestyle or clinical interventions.

Original languageEnglish (US)
Pages (from-to)1204-1212
Number of pages9
JournalCirculation
Volume129
Issue number11
DOIs
StatePublished - 2014

Keywords

  • Adolescence
  • Atherosclerosis
  • HIV
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Patel, K., Wang, J., Jacobson, D. L., Lipshultz, S. E., Landy, D. C., Geffner, M. E., DiMeglio, L. A., Seage, G. R., Williams, P. L., Van Dyke, R. B., Siberry, G. K., Shearer, W. T., Young, L., Scott, G. B., Wilkinson, J. D., Fisher, S. D., Starc, T. J., & Miller, T. L. (2014). Aggregate risk of cardiovascular disease among adolescents perinatally infected with the human immunodeficiency virus. Circulation, 129(11), 1204-1212. https://doi.org/10.1161/CIRCULATIONAHA.113.001978