Infectious Disease

Researchers found that children aged 1 to 2 years who take anti-HIV drugs have higher cholesterol levels compared with children the same age who do not have HIV.

For the study, researchers reviewed medical records of 764 children who had been exposed to HIV in the womb; of these, 83 were HIV-positive. They then compared cholesterol and triglyceride measurements in four groups:

• HIV-negative children.
• HIV-positive children not receiving drug therapy.
• HIV-positive children receiving antiretroviral therapy (ART) with protease inhibitors.
• HIV-positive children receiving other types of ART.

All children received periodic physical examinations, including evaluation of HIV status and cholesterol and triglyceride levels during the first 2 years of life. Fifty-nine percent of the children with HIV were receiving drug therapy during the course of the study.

According to results, the highest cholesterol levels were observed in children who took protease inhibitors. The average cholesterol reading in this group was 169 mg/dL compared with 152 mg/dL for children with HIV taking other ART and 147 mg/dL for children the same age without HIV. In contrast, children with HIV who were not taking any anti-HIV medication had relatively low cholesterol levels — more than 200 mg/dL.

Overall, about 11% of young children with HIV had cholesterol levels of more than 200 mg/dL.

Cholesterol levels among children with HIV who were not on medication tended to be 50% less than those who did not have HIV. However, cholesterol levels among toddlers receiving medication tended to be above the 50th percentile level of their uninfected peers. The number of children on protease inhibitors with cholesterol levels above the 95th percentile was notable, the researchers said.

In addition, children who took protease inhibitors also had the highest average triglyceride levels (211 mg/dL). Children taking other anti-HIV drugs had an average triglyceride level of 106.8 mg/dL, and those not taking any anti-HIV drugs had an average triglyceride level of 139.4 mg/dL.

“It’s likely that these children will be taking antiretroviral drugs for a lifetime. Our findings suggest that it would be a good idea for young children taking protease inhibitors to have their cholesterol monitored periodically to determine whether they face any increased risk of heart disease as they grow older,” Rohan Hazra, MD, of the pediatric, adolescent and maternal AIDS branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, said in a press release.

The current study is the first to look at children aged 12 to 23 months, according to Hazra. Other studies have shown that adults and older children taking protease inhibitors also develop high cholesterol levels.

The study was conducted in five Latin American and Caribbean countries.

Disclosure: Dr. Hazra reports no relevant financial disclosures.

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