Longitudinal Assessment of Lipoprotein(a) Levels in Perinatally HIV-Infected Children and Adolescents

Area of Science:

• Cardiology
• Infectious Diseases
• Pediatrics

Background:

• Human Immunodeficiency Virus (HIV) infection is an independent risk factor for cardiovascular disease (CVD).
• Perinatally HIV-infected (PHIV) children may have an increased risk of developing CVD later in life.
• Lipoprotein(a) (Lp(a)) is a recognized risk factor for CVD in the general population.

Purpose of the Study:

• To assess cardiovascular disease (CVD) risk in perinatally HIV-infected (PHIV) children by evaluating their lipid profiles, with a focus on Lipoprotein(a) (Lp(a)).

Main Methods:

• Two substudies were conducted: one assessing lipid profiles in 36 PHIV children (2012-2020), and another comparing lipid profiles in 21 PHIV adolescents and 23 controls over 4.6 years.
• Mixed models were used to analyze trends in lipid profiles and their determinants, including patient and disease characteristics.
• Lipid profiles, including Lp(a) levels, were measured and compared between groups.

Main Results:

• In the first substudy, 58% of PHIV children exhibited persistently elevated Lp(a) levels (median: 374 mg/L).
• The majority of PHIV children were of Black ethnicity (92%).
• In the second substudy, lipid profiles were comparable between PHIV adolescents and controls, but increases in LDL-cholesterol and total cholesterol were associated with higher Lp(a) levels in both studies.

Conclusions:

• A significant proportion of PHIV children and adolescents present with elevated Lp(a) levels, potentially linked to ethnic background.
• These elevated Lp(a) levels may contribute to an increased cardiovascular disease (CVD) risk in this population.
• Further research is warranted to understand the long-term implications of these findings for PHIV individuals.