Dataset Information

APOC3 Gene Polymorphism and Antiretroviral Therapy-Induced Dyslipidemia in HIV-Infected Children.

ABSTRACT: Children exposed to antiretroviral therapy (ART) are at risk of developing metabolic complications. The association between gene polymorphisms and the development of dyslipidemia in children post ART initiation was studied. Children initiating first-line ART were followed for 2 years at the National Institute for Research in Tuberculosis (Chennai, India), and St. John's Medical College Hospital (Bangalore, India). Clinical examination and fasting serum lipid profiles were measured every 6 months. Participants were genotyped for the polymorphisms in the APOC3 gene (rs2854116; rs2854117, and rs5128). Changes in lipid levels from baseline to months 6, 12, and 24, and the difference between the various genotype variants were analyzed using a modified analysis of variance test. Study enrolled 393 ART-naive HIV-infected children (mean age: 7.6 ± 3 years, mean weight: 18 ± 6) of whom 289 (75%) were started on nevirapine (NVP)-based ART and the remaining 96 (25%) were started on efavirenz-based ART. Only children carrying the GG allele of rs5128 genotype showed a decrease in CD4% and serum triglycerides pre-ART. An increasing trend of total cholesterol, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol were seen at 6 months in both EFZ and NVP groups, which subsequently stabilized by 12 months irrespective of genotype variants. Genotype variants of APOC3 (rs2854116 and rs2854117 polymorphism) did not show significant changes in serum lipid levels after 24 months of ART, whereas rs5128 polymorphism with "G" allele showed an association with HDL-c levels when on NVP-based ART. Our results suggest that ART plays a major role in normalizing lipid levels in HIV-infected children and APOC3 polymorphisms may not play a significant role in ART-induced dyslipidemia.

SUBMITTER: Srinivasan R

PROVIDER: S-EPMC7876358 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundWorldwide prevalence of dyslipidemia in HIV-infected children on antiretroviral medications (ARVs) is rising due to extensive use of treatment during their entire lives. Dyslipidemia is the potential side effect of ARVs, especially in individuals taking protease inhibitors. The objective of this study was to determine the prevalence of dyslipidemia in HIV-infected children on ARVs receiving care at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania.MethodsThis was a cross-sectional hospital-based study conducted from September 2015 to May 2016 at KCMC. HIV-infected children and adolescents less than 17 years on ARVs for more than 6 months were enrolled. Blood samples were taken to determine levels of triglycerides (TGs), total cholesterol, lipoproteins (including low-density lipoprotein (LDL) and high-density lipoprotein (HDL)), CD4+ T cells, and viral load (VL). Anthropometric measurements were used to assess nutritional status. SPSS 20.0 was used for analysis. Logistic regression estimated odds ratio (OR) and 95% confidence interval (CI), and P value <.05 was considered significant. Written consent was obtained from parents/guardians on behalf of their children and assent for older children.ResultsA total of 260 participants were included in the study; the median age at HIV diagnosis was 3 (interquartile range (IQR) = 1-6) years. The overall prevalence of dyslipidemia was 46.5% with hypercholesterolemia (⩾200 mg/dl) of 11.2%, HDL (<35 mg/dl) of 22.7%, LDL (⩾130 mg/dl) of 7.7%, and hyperglyceridemia (TG ⩾150 mg/dl) of 12.3%. Children aged between 6 and 12 years at HIV diagnosis had 2.7 times higher odds of developing dyslipidemia compared with younger age at diagnosis (OR = 2.7; 95% CI = 1.1-6.6). Patients with advanced (OR = 6.4; 95% CI = 1.5-27.1) or severe (OR = 9.8; 95% CI = 1.2-76.5) HIV-associated immunodeficiency at diagnosis had higher odds of developing dyslipidemia. Protease inhibitor use was associated with higher odds of developing dyslipidemia (OR = 3.1; 95% CI = 1.4-7.1).ConclusionLate diagnosis of HIV at 6 years of age or more, advanced, or severe immunosuppression, and the use of protease inhibitors were independent predictors of dyslipidemia in children on ARVs after 6 months of treatment, and with low HDL levels observed most commonly. Monitoring lipid profiles in children, especially those on protease inhibitors and with advanced/severe immunosuppression at diagnosis, may help in preventing future complications.

Project description:BackgroundAntiretroviral therapy (ART) has decreased mortality so that increasing numbers of children with HIV are reaching adolescence. However, longstanding HIV infection and/or its treatment in children is associated with noninfectious complications including cardiac disease. We investigated the prevalence, spectrum and risk factors for echocardiographic abnormalities among children established on ART.MethodsHIV-infected children aged 6-16 years, on ART at least 6 months were enrolled into a cross-sectional study from a public-sector paediatric HIV clinic in Harare, Zimbabwe. A standardized examination including transthoracic echocardiography was performed. Local echocardiographic reference ranges were used to define cardiac abnormalities. Logistic regression was used to examine the association between cardiac abnormalities and risk factors.ResultsOf the 201participants recruited, 92 (46%) were girls and median age was 11 (IQR 9-12) years; CD4+ cell count was 727?cells/?l (IQR 473-935) and 154 (78%) had viral load less than 400?copies/ml. Echocardiographic abnormalities were found in 83 (42%); left ventricular (LV) diastolic dysfunction was the most common abnormality 45 (23%) and LV hypertrophy in 22 (11%). LV and left atrial dilatation were found in 9 (5%) and 16 (8%), respectively. Right ventricular dilatation and systolic dysfunction were found in 13 (7%) and 4 (2%), respectively, of whom 60% had concurrent left heart abnormalities. Current use of nevirapine was associated with LVH [aOR 3.14 (1.13-8.72; P?=?0.03)] and hypertension was associated with LV diastolic dysfunction [aOR 3.12 (1.48-6.57; P?<?0.01)].ConclusionHIV-infected children established on ART have a high burden of echocardiographic abnormalities. Right heart disease was predominantly associated with left heart abnormalities and may be part of a global cardiomyopathic process. Further studies are needed to investigate the natural history, aetiology, and pathogenesis of these abnormalities, so that appropriate monitoring and treatment strategies can be developed.

Project description:BackgroundUndernutrition and malnutrition in children in low- and middle-income countries contribute to high mortality rates. Stunting, a prevalent form of malnutrition, is associated with educational and productivity losses. Environmental enteric dysfunction (EED) and human immunodeficiency virus (HIV) infection worsen these conditions. This study seeks to investigate the presence of enteropathy using EED fecal biomarkers in HIV-infected children who are stable on antiretroviral therapy (ART) across various nutritional statuses. By understanding the interplay between EED, HIV, and nutritional status, this study aims to provide insights that can inform targeted interventions to optimize nutritional outcomes in HIV infected children.Methods/principal findingsThis study evaluated the levels of alpha-1-antitrypsin, calprotectin and myeloperoxidase in frozen fecal samples from 61 HIV infected (mean age 9.16 ±3.08 years) and 31 HIV uninfected (6.65 ±3.41 years) children in Malawi. Anthropometric measurements and clinical data were collected. The height-for-age z-score (-1.66 vs -1.27, p = 0.040) and BMI-for-age z-score (-0.36 vs 0.01, p = 0.037) were lower in HIV infected children. Enzyme-linked immunosorbent assays were used to measure biomarker concentrations. Statistical tests were applied to compare biomarker levels based on HIV status and anthropometric parameters. Myeloperoxidase, alpha-1-antitrypsin, and calprotectin concentrations did not differ between HIV infected and HIV uninfected children of different age groups. In HIV infected children from 5-15 years, there is no difference in biomarker concentration between the stunted and non-stunted groups.Conclusion/significanceOur study found a higher prevalence of stunting in HIV infected children compared to uninfected children, but no significant differences in biomarker concentrations. This suggests no causal relationship between enteropathy and stunting in HIV infected children. These results contribute to the understanding of growth impairment in HIV infected children and emphasize the need for further research, particularly a longitudinal, biopsy-controlled study.

Dataset Information

APOC3 Gene Polymorphism and Antiretroviral Therapy-Induced Dyslipidemia in HIV-Infected Children.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets