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Lipid and glucose abnormalities and associated factors among children living with HIV in Asia

Suwanlerk T 1 , Rupasinghe D 2 , Jantarabenjakul W 3 , An VT 4 , Ross JL 1 , Kariminia A 2 Show all authors , Van Lam N 5 , Kinikar A 6 , Ounchanum P 7 , Puthanakit T 3 , Nik Yusoff NK 8 , Lumbiganon P 9 , Chokephaibulkit K 10 , Viet DC 4 , Sudjaritruk T 11 , Moy FS 12 , Wati DK 13 , Mohamed TJ 14 , Nallusamy R 15 , Kumarasamy N 16 , Khol V 17 , Khanh TH 18 , Kurniati N 19 , TREAT Asia pediatric HIV Observational Database (TApHOD)

Affiliations 

  • 1 TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
  • 2 The Kirby Institute, UNSW Sydney, Sydney, Australia
  • 3 Department of Pediatrics, Faculty of Medicine and Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand
  • 4 Infectious Diseases Department, Children's Hospital 2, Ho Chi Minh City, Vietnam
  • 5 Infectious Diseases Department, National Hospital of Pediatrics, Hanoi, Vietnam
  • 6 BJ Medical College and Sassoon General Hospitals, Maharashtra, India
  • 7 Department of Pediatrics, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
  • 8 Department of Pediatrics, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
  • 9 Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • 10 Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 11 Department of Pediatrics, Faculty of Medicine, and Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
  • 12 Department of Pediatrics, Hospital Likas, Kota Kinabalu, Malaysia
  • 13 Department of Pediatrics, Prof. Dr. I.G.N.G Ngoerah Hospital, Udayana University, Bali, Indonesia
  • 14 Department of Pediatrics, Women and Children Hospital Kuala Lumpur (WCHKL), Kuala Lumpur, Malaysia
  • 15 Department of Pediatrics, Penang Hospital, Penang, Malaysia
  • 16 VHS-Infectious Diseases Medical Centre, Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), Voluntary Health Services, Chennai, India
  • 17 National Centre for HIV/AIDS, Dermatology and STDs, Phnom Penh, Cambodia
  • 18 Infectious Diseases Department, Children's Hospital 1, Ho Chi Minh City, Vietnam
  • 19 Department of Child Health, Universitas Indonesia - Cipto Mangunkusumo General Hospital, Indonesia
Antivir Ther, 2023 Apr;28(2):13596535231170751.
PMID: 37114944 DOI: 10.1177/13596535231170751

Abstract

BACKGROUND: Children living with HIV (CLHIV) on prolonged antiretroviral therapy (ART) are at risk for lipid and glucose abnormalities. Prevalence and associated factors were assessed in a multicentre, Asian longitudinal paediatric cohort.

METHODS: CLHIV were considered to have lipid or glucose abnormalities if they had total cholesterol ≥200 mg/dL, high-density lipoprotein (HDL) ≤35 mg/dL, low-density lipoprotein (LDL) ≥100 mg/dL, triglycerides (TG) ≥110 mg/dL, or fasting glucose >110 mg/dL. Factors associated with lipid and glucose abnormalities were assessed by logistic regression.

RESULTS: Of 951 CLHIV, 52% were male with a median age of 8.0 (interquartile range [IQR] 5.0-12.0) years at ART start and 15.0 (IQR 12.0-18.0) years at their last clinic visit. 89% acquired HIV perinatally, and 30% had ever used protease inhibitors (PIs). Overall, 225 (24%) had hypercholesterolemia, 105 (27%) low HDL, 213 (58%) high LDL, 369 (54%) hypertriglyceridemia, and 130 (17%) hyperglycemia. Hypercholesterolemia was more likely among females (versus males, aOR 1.93, 95% CI 1.40-2.67). Current PIs use was associated with hypercholesterolemia (current use: aOR 1.54, 95% CI 1.09-2.20); low HDL (current use: aOR 3.16, 95% CI 1.94-5.15; prior use: aOR 10.55, 95% CI 2.53-43.95); hypertriglyceridemia (current use: aOR 3.90, 95% CI 2.65-5.74; prior use: aOR 2.89, 95% CI 1.31-6.39); high LDL (current use: aOR 1.74, 95% CI 1.09-2.76); and hyperglycemia (prior use: aOR 2.43, 95% CI 1.42-4.18).

CONCLUSION: More than half and one-fifth of CLHIV have dyslipidemia and hyperglycemia, respectively. Routine paediatric HIV care should include metabolic monitoring. The association between PIs use and dyslipidemia emphasizes the importance of rapidly transitioning to integrase inhibitor-containing regimens.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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