Children, adolescents living with HIV have higher rates of risk factors for cardiovascular issues

Children and adolescents living with HIV have higher rates of risk factors for cardiovascular issues than HIV-negative children and adolescents, according to a study published in the June issue of the Journal of Pediatrics, the Miami Herald reports. In addition, many antiretroviral drugs can increase cardiovascular risk factors, the Herald reports.

Tracie Miller, a professor of pediatrics at the University of Miami Miller School of Medicine, and colleagues in the multi-hospital study followed 42 HIV-positive children from 1998 to 2003 who contracted the disease through mother-to-child transmission. The study found that HIV-positive children had triglyceride levels 50% higher than children not living with the virus. The study also found that among the HIV-positive children, cholesterol levels were 6% higher, and LDL, or "bad cholesterol," was 10% higher. In addition, HDL, or "good" cholesterol, was 13% lower among the HIV-positive children when compared with HIV-negative children. According to the Herald, all four are key risk factors for heart disease. In addition, the antiretroviral zidovudine -- which is given to HIV-positive pregnant women to prevent MTCT -- has been found to increase children's cardiac risks.

Although other antiretrovirals, such as non-nucleoside transcriptase inhibitors, have been associated with lower lipid levels, Miller said people living with the disease often need a combination of antiretrovirals. The increased cardiovascular issues associated with being HIV-positive and taking antiretrovirals is "a double whammy" for children and adolescents, Miller said. She added, "We know that adults with HIV have a seven-to-10-times higher risk of having a heart attack than other adults. The fear is that the same factors are at work in children from birth to 20." According to Miller, it will take decades to determine whether the higher risk factors observed in the study will translate into more heart attacks and higher death rates.

Miller has designed a program for HIV-positive children that includes education, monitoring, diet, lifestyle and exercise, the Herald reports. She said that it is important for children living with the disease to avoid high-fat and sugar-rich foods, as well as alcohol and tobacco. Miller is starting another study to determine if such lifestyle changes help reduce cardiovascular risk, the Herald reports (Tasker, Miami Herald, 6/24).