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Published on: February 7, 2015
Long-term changes in carotid intima-media thickness among HIV-infected children and young adults
Allison Ross Eckard1, Mary Ann O'Riordan, Norma Storer
1Emory University School of Medicine, Atlanta, GA, USA.
Insights
HIV-infected children showed minimal long-term changes in carotid intima-media thickness (IMT), a marker for cardiovascular disease (CVD) risk, despite yearly fluctuations. This suggests a stable vascular profile over time in this population.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Vascular Biology
Background:
- HIV infection is linked to increased cardiovascular disease (CVD) risk.
- Carotid intima-media thickness (IMT) serves as a surrogate marker for CVD.
- Assessing long-term IMT changes in HIV-infected children is crucial for understanding CVD progression.
Purpose of the Study:
- To evaluate long-term changes in carotid IMT in HIV-infected children and young adults.
- To compare IMT progression between HIV-infected subjects and healthy controls.
Main Methods:
- A longitudinal, observational study design was employed.
- Carotid IMT was measured over 144 weeks in HIV-infected subjects (ages 2-21) and matched controls.
- 34 HIV-infected subjects and 29 controls were analyzed.
Main Results:
- At baseline, HIV-infected subjects had increased internal carotid artery (ICA) and common carotid artery (CCA) IMT compared to controls.
- While yearly IMT varied in both groups, no significant net change in ICA or CCA IMT was observed in HIV-infected subjects by week 144.
- Controls showed an increase in CCA and ICA IMT over the study period, with similar IMT between groups by 144 weeks.
Conclusions:
- Despite short-term variations, HIV-infected children exhibited minimal net change in carotid IMT over 144 weeks.
- Arterial growth or luminal diameter changes likely account for yearly IMT fluctuations.
- This suggests a relatively stable vascular profile in HIV-infected children regarding IMT, despite their elevated CVD risk.
Background:
HIV-infected patients are at increased risk of cardiovascular disease (CVD). This study assessed long-term changes in carotid intima-media thickness (IMT) as a surrogate marker for CVD risk in HIV-infected children and young adults.
Methods:
This was a longitudinal, observational study comparing carotid IMT in HIV-infected subjects who were 2-21 years old to matched controls over 144 weeks.
Results:
A total of 34 HIV-infected subjects and 29 controls were included in the analyses. Among the HIV-infected group, median age was 10 years, 74% were black, and 65% were female. Overall, 91% were perinatally-infected with 82% on antiretroviral therapy and a median CD4(+) T-cell count of 681 cells/mm(3). At baseline, HIV-infected subjects had increased internal carotid artery (ICA) and common carotid artery (CCA) IMT (ICA, HIV-infected 0.90 mm versus controls 0.73 mm; P<0.01; CCA, HIV-infected 1.00 mm versus controls 0.90 mm; P=0.02). Relatively large changes in ICA and CCA IMT were seen from year to year in both groups. However, by week 144, there were no net changes in ICA or CCA IMT within the HIV-infected group. In the controls, CCA increased 0.1 mm and ICA increased 0.17 mm from baseline to week 144. ICA and CCA IMT were similar between groups by 144 weeks.
Conclusions:
Despite variations from year to year in carotid IMT in HIV-infected children and healthy controls, likely due to arterial growth and/or luminal diameter change, little or no net change occurred in carotid IMT over the entire 144-week study period. This suggests that only small net changes occur over time in HIV-infected children despite an increased long-term risk of CVD.
