OBJECTIVES: The risk of cardiometabolic complications in children with perinatally acquired HIV infection (PHIVs) and in perinatally HIV-exposed but uninfected children (HEUs) and its relationship to systemic inflammation and markers of gut integrity are not well established. In this current study, we assed insulin resitance in PHIV compared to HEUs and HIV unexposed uninfected children and explored potential association with intestinal damage biomarkers. METHODS: This was a cross-sectional study in PHIVs, HEUs and HIV-unexposed, uninfected children (HUUs) aged 2-10 years enrolled in Uganda. PHIVs were on stable antiretroviral therapy (ART) with HIV viral load /= 0.05). After adjusting for age and sTNFRI, BMI remained independently associated with the HOMA-IR index (beta = 0.16; P < 0.01). CONCLUSIONS: Despite viral suppression, Ugandan PHIVs have disturbances in glucose metabolism. Higher BMI, and not immune activation or alteration of gut integrity, was associated with insulin resistance in this population.
BACKGROUND: Children with perinatally acquired HIV (PHIVs) face a lifelong cumulative exposure to HIV and ART. The relationship between gut integrity, microbial translocation and inflammation in PHIV is poorly understood. METHODS: This is a cross-sectional study in 57 PHIVs, 59 HIV exposed uninfected (HEUs) and 56 HIV unexposed uninfected (HIV-) children aged 2-10 years old in Uganda. PHIVs were on stable ART with HIV-1 RNA 0.05). Among PHIVs who were breastfed, levels of sCD163 and IL6 were hig...
BACKGROUND: Fat accumulation and insulin resistance remain a threat to the success of antiretroviral therapy (ART). The role of gut dysfunction in metabolic complications associated with ART initiation is unclear. METHODS: Human immunodeficiency virus (HIV)-infected ART-naive participants were randomized to tenofovir disoproxil fumarate/emtricitabine plus atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (RAL). Changes in the gut integrity markers zonulin, lipopolysaccharide-binding prot...
BACKGROUND: HIV-exposed-uninfected (HEU) infants have increased infectious morbidity and mortality; little is known about their levels of inflammation and monocyte activation. METHODS: Plasma samples obtained at birth and 6 months from 86 HEU mother-infant pairs enrolled in the National Institute of Child Health and Human Development cohorts in Brazil were compared with 88 HIV-unexposed mother-infant pairs. HIV-infected mothers received antiretroviral therapy during pregnancy, their infants rece...
#1Lisa Frigati(UCT: University of Cape Town)H-Index: 9
#2Jennifer Jao(ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 13
Last. Heather J. Zar(UCT: University of Cape Town)H-Index: 66
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Abstract To investigate the prevalence of and risk factors for insulin resistance (IR) in a cohort of youth living with perinatally acquired HIV (YLPHIV) receiving antiretroviral treatment (ART). A...
Last. Mario J.A. Saad(State University of Campinas)H-Index: 75
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Abstract Here we review how immune activation and insulin resistance contribute to the metabolic alterations observed in HIV-infected patients, and how these alterations increase the risk of developing CVD. The introduction and evolution of antiretroviral drugs over the past 25 years has completely changed the clinical prognosis of HIV-infected patients. The deaths of these individuals are now related to atherosclerotic CVDs, rather than from the viral infection itself. However, HIV infection, c...
In HIV-infected patients, the damage in the gut mucosal immune system is not completely restored after antiretroviral therapy (ART). It results in microbial translocation, which could influence the immune and inflammatory response. We aimed at investigating the long-term impact of bacterial-DNA translocation (bactDNA) on glucose homeostasis in an HIV population. This was a cohort study in HIV-infected patients whereby inclusion criteria were: patients with age >18 years, ART-naive or on effectiv...
Introduction. Obesity is a risk factor to develop metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM). Insulin resistance (IR) plays a major part in both. With increasing incidence of childhood obesity, this retrospective study aimed to identify predictors of IR in children/adolescents with obesity to optimize screening for IR. Method. Patients aged ≥ 2–≤ 18 years with obesity (BMI-SDS > 2.3) were included. IR was defined as HOMA-IR ≥ 3.4, and MetS if ≥3 of the following criteria were ...
Objective: To compare prevalence of insulin resistance between perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected adolescents (PHEU), determine incidence of and contributory factors to new and resolved cases of insulin resistance in PHIV+, and evaluate glucose metabolism. Design: Cross-sectional design for comparison of prevalence among PHIV+ and PHEU. Longitudinal design for incidence and resolution of insulin resistance among PHIV+ at risk for these outcomes. Methods:...
BACKGROUND: Few studies have investigated metabolic complications in HIV-infected African children and their relation with inflammation. METHODS:: We compared baseline and changes in insulin resistance (HOMA-IR) and in markers of inflammation over 48 weeks, in a subset of antiretroviral therapy (ART) naive Ugandan children from the CHAPAS-3 trial randomized to zidovudine (AZT), stavudine (D4T) or abacavir (ABC) based regimens. Non-parametric methods were used to explore between and within group ...
OBJECTIVE: To estimate the incidence of lipid and glucose abnormalities and assess their association with exposure to antiretroviral (ARV) regimens among perinatally HIV-infected Latin American children. DESIGN: Longitudinal cohort study. METHODS: Data were analyzed from the Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative Pediatric Latin American Countries Epidemiologic Study. The incidence of dyslipidemia [total cholester...
An unexpected increase in weight gain has recently been reported in the course of integrase strand transfer inhibitors (INSTI) treatment. The possibility of this effect in people who are perinatally infected with HIV (PHIV) and thus exposed to lifelong therapy needs to be explored. This is a retrospective multicenter case-control study. Adults with PHIV followed between 2010 and 2019 in two outpatient services in Northern Italy were included if they had at least two weight measures in two succes...
