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[Premature Atherosclerosis in HIV-Infected Pediatric Patients: Literature Review and Clinical Approach]

Paula Martins1, Eduardo Castela2, Graça Rocha3

  • 1Serviço de Cardiologia Pediátrica. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal; Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal.

Acta Medica Portuguesa
|December 22, 2017
PubMed

Insights

Children and adolescents with human immunodeficiency virus (HIV) face higher risks of early cardiovascular disease due to a complex interplay of the virus, antiretroviral therapy, and lifestyle factors accelerating atherosclerosis.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Cardiovascular Health

Background:

  • Human immunodeficiency virus (HIV) infection in pediatric populations presents unique challenges.
  • Children and adolescents with HIV have an elevated risk of premature cardiovascular disease.
  • Accelerated atherosclerosis is a significant concern in this demographic.

Purpose of the Study:

  • To explore the multifactorial nature of accelerated atherosclerosis in pediatric HIV.
  • To identify key mediators of cardiovascular risk in HIV-infected youth.
  • To outline current clinical strategies for cardiovascular prevention in this population.

Main Methods:

  • Review of existing literature on HIV, antiretroviral therapy, and cardiovascular outcomes in pediatrics.
  • Analysis of the interplay between viral factors, treatment, and lifestyle.
  • Identification of pathophysiological mechanisms contributing to atherosclerosis.

Main Results:

  • Accelerated atherosclerosis in pediatric HIV is driven by the virus, antiretroviral therapy, and lifestyle.
  • Key mediating factors include dyslipidemia, metabolic dysregulation, lipodystrophy, inflammation, endothelial dysfunction, and a prothrombotic state.
  • Cardiovascular risk is multifactorial and complex in this vulnerable group.

Conclusions:

  • Effective management of HIV infection is crucial for cardiovascular prevention.
  • Addressing modifiable risk factors and promoting healthy lifestyles are essential components of care.
  • A comprehensive approach is necessary to mitigate premature cardiovascular disease in HIV-infected children and adolescents.

Keywords:
Anti-Retroviral AgentsAtherosclerosisChildHIV InfectionsRisk Factors

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