Young Have More Heart Risk

HIV-positive children and adolescents have worse cardiac risk profiles than their uninfected peers, and many drugs used to fight the virus exacerbate those risks, a new study shows.

"We know that adults with HIV have a seven- to 10-times higher risk of having a heart attack than other adults," said Dr. Tracie Miller, a study coauthor at the University of Miami School of Medicine. But the fear is that those same heart attack risk factors might get an earlier start among youths with HIV. Whether those factors will translate into more heart attacks and deaths for children who grow up HIV-positive will take decades to determine, Miller said.

The 1998-2003 study involved 42 children who were infected at birth by their HIV-positive mothers. The HIV-positive youths had triglyceride levels 50 percent higher than their uninfected peers; total cholesterol was 6 percent higher; LDL or "bad" cholesterol was 10 percent higher; and HDL or "good" cholesterol was 13 percent lower.

Non-nucleoside reverse transcriptase inhibitors have been associated with lower lipid levels, said Miller, while the protease inhibitor zidovudine has been found to increase children's cardiac risks.

It is important for HIV-positive children to avoid alcohol, tobacco, and food that is high in fat or sugar, said Miller. A problem is that as HIV-infected kids feel as healthy as their peers, they may adopt the same sedentary lifestyles and poor diets, she said.

"We have a dietitian who explains the risk factors and talks about nutrition and cardiac risks," said Yuri Velasquez, a counselor with a University of Miami project who works with HIV-positive youths ages 13-24. "They listen. Over time, they change a little bit."

The full study, "Risk Factors for Cardiovascular Disease in Children Infected with Human Immunodeficiency Virus-1," was published in the Journal of Pediatrics (2008;doi: 10.1016/jpeds.2008.04016).

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