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J Acquir Immune Defic Syndr. 2014 Jan 1;65(1):42-9. doi: 10.1097/QAI.0b013e3182a9466a.

Subclinical atherosclerosis and markers of immune activation in HIV-infected children and adolescents: the CaroVIH Study.

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  • 1*Laboratorio de InmunoBiología Molecular, Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; †Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, Spain; ‡Unidad de Cardiología Infantil, Hospital General Universitario Gregorio Marañón, Madrid, Spain; §Unidad de Inmunodeficiencias, Servicio de Pediatría, Hospital Universitario Doce de Octubre, Madrid, Spain; ‖Servicio de Pediatría, Hospital Universitario La Paz, Madrid, Spain; ¶Servicio de Pediatría, Hospital de Getafe, Madrid, Spain; #Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, and IRYCIS, Madrid, Spain; **Servicio de Pediatría, Hospital Universitario Niño Jesús, Madrid, Spain; and ††Servicio de Pediatría, Hospital Carlos III, Madrid, Spain.

Abstract

BACKGROUND:

HIV-infected adults display increased cardiovascular disease, probably driven by inflammation and immune activation. These relationships have not been addressed in vertically HIV-infected children and adolescents, a population at very high risk for long-term non-AIDS complications.

METHODS:

Carotid intima media thickness (IMT) was measured in a cohort of HIV-infected children and adolescents and healthy controls. C-reactive protein and markers of immune activation (CD38⁺HLA-DR⁺) and immune senescence (CD28⁻CD57⁺) were determined.

RESULTS:

One hundred fifty HIV-infected patients and 150 controls were included, 64.8% female. IMT was thicker in HIV-infected patients (0.434 mm ± 0.025 vs. 0.424 mm ± 0.018, P < 0.001). After adjustment by age, sex, body mass index, and smoking status, HIV infection was independently associated with thicker IMT (odds ratio, 2.28; 95% confidence interval: 1.25 to 4.13; P = 0.007). Among HIV-related variables, a low CD4 nadir was related to an increased IMT. Although HIV-infected subjects presented higher frequencies of activated CD4⁺ and CD8⁺ T cells (P = 0.002 and P = 0.087, respectively), no relation was found between IMT and inflammation, immune activation, or senescence.

CONCLUSIONS:

Structural changes of the vasculature present early in vertically HIV-infected subjects as well as immune activation and senescence. These patients should be carefully monitored for the prompt detection and early treatment of cardiovascular disease.

PMID:
23982657
DOI:
10.1097/QAI.0b013e3182a9466a
[PubMed - indexed for MEDLINE]
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