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Multicenter Study
. 2011 Aug 15;57(5):413-20.
doi: 10.1097/QAI.0b013e31822203f5.

Clinical management and follow-up of hypercholesterolemia among perinatally HIV-infected children enrolled in the PACTG 219C study

Denise L Jacobson  1 , Paige Williams, Katherine Tassiopoulos, Ann Melvin, Rohan Hazra, John Farley
Affiliations
Multicenter Study

Clinical management and follow-up of hypercholesterolemia among perinatally HIV-infected children enrolled in the PACTG 219C study

Denise L Jacobson et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Hypercholesterolemia is common in perinatally HIV-infected (HIV+) children, but little is known about the clinical course and management in this population.

Methods: We studied HIV+ children in a multisite prospective cohort study (Pediatric AIDS Clinical Trials Group 219C) and considered follow-up for 2 years after development of hypercholesterolemia. We estimated the time and factors associated with resolution of hypercholesterolemia and described changes in antiretroviral regimen and use of lipid-lowering medications. We defined incident hypercholesterolemia as entry total cholesterol (cholesterol) <220 mg/dL and 2 subsequent consecutive cholesterol ≥ 220 mg/dL and defined resolution of hypercholesterolemia as 2 consecutive cholesterol <200 mg/dL after incident hypercholesterolemia.

Results: Among 240 incident hypercholesterolemia cases, 81 (34%) had resolution to normal cholesterol within 2 years of follow-up (median follow-up = 1.9 years). The median age of cases was 10.3 years with 54% non-Hispanic black and 53% male. Resolution to normal cholesterol was more likely in children who changed antiretroviral regimen (adjusted hazard ratio = 2.37, 95% confidence interval: 1.45 to 3.88) and who were 13 years and older (aHR = 2.39, 95% confidence interval: 1.33 to 4.27). Types of regimen changes varied greatly, and 15 children began statins.

Conclusion: The majority of children who develop hypercholesterolemia maintain elevated levels over time, potentially placing them at risk for premature cardiovascular morbidity.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Figure 1
Figure 1
Time to Drop in Total Cholesterol Below 200 mg/dl Over Two Years of Follow-up by Age (yrs) at Time of Hypercholesterolemia
Figure 2
Figure 2
Evolution of Total Cholesterol (mg/dl) Within Two Years After Incident Hypercholesterolemia
See this image and copyright information in PMC

Comment in

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