Association of hypercholesterolemia incidence with antiretroviral treatment, including protease inhibitors, among perinatally HIV-infected children.
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Resum
BACKGROUND
Antiretroviral therapy has been associated with hypercholesterolemia in HIV-infected children. Few longitudinal studies have been conducted to examine this association, however.
OBJECTIVE
To evaluate the incidence of and risk factors for development of hypercholesterolemia in a large pediatric study.
METHODS
Prospective cohort study (Pediatric AIDS Clinical Trials Group 219C).
METHODS
A total of 2122 perinatally HIV-infected children free of hypercholesterolemia at entry.
RESULTS
Development of hypercholesterolemia (total cholesterol >or=220 mg/dL at 2 consecutive visits). Cox proportional hazards models were used to evaluate risk factors.
RESULTS
Thirteen percent of children had hypercholesterolemia at entry, and an additional 13% developed hypercholesterolemia during follow-up for an incidence rate of 3.4 cases per 100 person-years (95% confidence interval [CI]: 3.0 to 3.9). After adjustment for age, boosted protease inhibitor (PI) use (hazard ratio [HR] = 13.9, 95% CI: 6.73 to 28.6), nonboosted PI use (HR = 8.65, 95% CI: 4.19 to 17.9), and nonnucleoside reverse transcriptase inhibitor use (HR = 1.33, 95% CI: 1.04 to 1.71) were associated with increased risk of hypercholesterolemia, and higher viral load was protective (>50,000 vs. CONCLUSIONS PIs were significant risk factors for hypercholesterolemia. Higher viral load was protective and may reflect nonadherence. Further follow-up is critical to evaluate long-term consequences of chronic PI exposure and hypercholesterolemia.
