Department of Pediatric Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, Location Academic Medical Center, 1100 DD Amsterdam, The Netherlands.
Department of Experimental Vascular Medicine and Vascular Medicine, Amsterdam UMC, Location Academic Medical Center, 1100 DD Amsterdam, The Netherlands.
Viruses. 2021 Oct 14;13(10):2067. doi: 10.3390/v13102067.
HIV is an independent risk factor of cardiovascular disease (CVD); therefore, perinatally HIV-infected (PHIV) children potentially have a greater CVD risk at older age. Lipoprotein(a) (Lp(a)) is an established risk factor for CVD in the general population. To evaluate a potential increased CVD risk for PHIV children, we determined their lipid profiles including Lp(a). In the first substudy, we assessed the lipid profiles of 36 PHIV children visiting the outpatient clinic in Amsterdam between 2012 and 2020. In the second substudy, we enrolled 21 PHIV adolescents and 23 controls matched for age, sex and ethnic background on two occasions with a mean follow-up time of 4.6 years. We assessed trends of lipid profiles and their determinants, including patient and disease characteristics, using mixed models. In the first substudy, the majority of PHIV children were Black (92%) with a median age of 8.0y (5.7-10.8) at first assessment. Persistent elevated Lp(a) levels were present in 21/36 (58%) children (median: 374 mg/L (209-747); cut off = 300). In the second substudy, the median age of PHIV adolescents was 17.5y (15.5-20.7) and of matched controls 16.4y (15.8-19.5) at the second assessment. We found comparable lipid profiles between groups. In both studies, increases in LDL-cholesterol and total cholesterol were associated with higher Lp(a) levels. A majority of PHIV children and adolescents exhibited elevated Lp(a) levels, probably associated with ethnic background. Nonetheless, these elevated Lp(a) levels may additionally contribute to an increased CVD risk.
艾滋病毒是心血管疾病（CVD）的独立危险因素；因此，围生期感染艾滋病毒的（PHIV）儿童在年龄较大时可能面临更大的 CVD 风险。脂蛋白（a）（Lp(a)）是普通人群中 CVD 的既定危险因素。为了评估 PHIV 儿童潜在的 CVD 风险增加，我们确定了他们的血脂谱，包括 Lp(a)。在第一项子研究中，我们评估了 2012 年至 2020 年期间在阿姆斯特丹门诊就诊的 36 名 PHIV 儿童的血脂谱。在第二项子研究中，我们在两次就诊时招募了 21 名 PHIV 青少年和 23 名匹配的对照者，年龄、性别和种族背景相同，平均随访时间为 4.6 年。我们使用混合模型评估了血脂谱及其决定因素的趋势，包括患者和疾病特征。在第一项子研究中，大多数 PHIV 儿童为黑人（92%），首次评估时的中位年龄为 8.0 岁（5.7-10.8）。21/36（58%）儿童持续存在升高的 Lp(a)水平（中位数：374mg/L（209-747）；截点=300）。在第二项子研究中，PHIV 青少年的中位年龄为 17.5 岁（15.5-20.7），匹配对照者的中位年龄为 16.4 岁（15.8-19.5），第二次评估时。我们发现两组之间的血脂谱相当。在两项研究中，LDL-胆固醇和总胆固醇的增加与 Lp(a)水平升高相关。大多数 PHIV 儿童和青少年表现出升高的 Lp(a)水平，可能与种族背景有关。尽管如此，这些升高的 Lp(a)水平可能会额外增加 CVD 风险。
