HIV infection and treatment linked to heart disease in children

Children infected with HIV show early signs of cardiovascular disease, particularly if they have been treated with protease inhibitors, according to the results of a study presented in the 5th July edition of Circulation. This suggests that children with HIV may be at an elevated risk of heart attack or stroke during adolescence or early adulthood. HIV infection and treatment with anti-HIV drugs are known to be risk factors for the development of cardiovascular disease in adults, resulting in an increased incidence of premature cardiovascular events like heart attacks or strokes. However, fewer data are available on the risk of cardiovascular disease faced by HIV-positive children.

To assess this risk, investigators from Great Ormond Street Hospital in London studied 83 children aged between five and 18 years who had been infected with HIV via mother-to-child transmission. The researchers measured the structure and function of their blood vessels, comparing them to measurements from a group of 59 HIV-negative children. “Structural and functional changes of the vasculature are already present during childhood in HIV-infected children,” they write. “These changes were most pronounced in children receiving protease inhibitors but were also observed in non-protease inhibitor-treated and untreated children. “Our findings support a role for both HIV infection itself and antiretroviral therapy, particularly protease inhibitors, in the pathogenesis of early vascular disease,” they conclude.

The HIV-positive children had greater carotid intima-media thickness (IMT) than the HIV-negative controls (mean 0.6 vs. 0.47mm; p < 0.001). IMT is a reliable marker of damage to blood vessels that can be measured with an ultrasound scan of the neck. Higher IMT values indicate a thickening of the inner wall of the artery and are predictive of the development of cardiovascular disease. The investigators also found that both age and HIV treatment were associated with IMT read more

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