Association between human immunodeficiency virus infection and arterial stiffness in children

Background: Human immunodeficiency virus infection (HIV) is associated with increased cardiovascular risk and adverse cardiovascular outcome in adults. Early recognition of changes in vascular properties might prove essential in cardiovascular prevention in HIV-infected patients. We investigated the relations between HIV infection and arterial stiffness in children. Methods: This cross-sectional study included 51 HIV-infected and 52 healthy children (age 3.2-14.5 years, 49 males). All infected children had acquired HIV by vertical transmission and were receiving antiretroviral therapy at time of assessment. Arterial stiffness was measured by pulse wave velocity and aortic augmentation index, using the Arteriograph system (Tensiomed Kft, Budapest, Hungary). We applied multivariable general linear modeling to evaluate the relationship between HIV infection and arterial stiffness with further adjustment for confounders and possible intermediary variables. Findings represent mean group differences with 95% confidence intervals and p values. Results: Aortic augmentation index was higher by 9.0% (5.6-12.5, p< 0.001) in HIV-infected than in healthy children. Adjustment for blood pressure, protease inhibitor use, biomarkers for level of inflammation, lipid-and glucose-metabolism, as possible intermediary variables, did not appreciably alter the results. There were no significant differences in pulse wave velocity between HIV-infected and healthy children (mean difference 0.28 m/ s, -0.14-0.69, p = 0.19). Conclusion: HIV-infected children have an increased aortic augmentation index, compared to healthy children. Early cardiovascular assessment may be important in targeted prevention for HIV-infected children.