Open AccessHyperlipidemia in HIV-Infected Children Treated With Protease Inhibitors: Relevance for Cardiovascular Diseases
Author(s) -
JeanJacques Cheseaux,
Valérie Jotterand,
Christoph Aebi,
Hanspeter Gnehm,
Christian Kind,
David Nadal,
Christoph Rudin,
Claire-Anne Wyler Lazarevitch,
Pascal Nicod,
Vincent Mooser
Publication year - 2002
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/00126334-200207010-00004
Subject(s) - nelfinavir , ritonavir , medicine , hyperlipidemia , cholesterol , heart disease , familial hypercholesterolemia , gastroenterology , protease inhibitor (pharmacology) , endocrinology , human immunodeficiency virus (hiv) , immunology , viral load , diabetes mellitus , antiretroviral therapy
Cases of severely hypercholesterolemic HIV-infected children taking protease inhibitors (PIs) have been reported. Because high cholesterol levels (> or =15 mmol/L), as seen in homozygous familial hypercholesterolemia (FH), may lead to heart disease in childhood, the authors performed a systematic retrospective survey of all plasma lipid levels recorded for children who had received ritonavir or nelfinavir between 1995 and 2001 in Switzerland. Administration of PIs was associated with a significant increase in plasma cholesterol levels, which was more pronounced for those given ritonavir (from 3.3 +/- 0.7 mmol/L, n = 5 to 6.3 +/- 2.8 mmol/L, n = 19 [mean +/- SD]; p =.03) than for nelfinavir (from 3.0 +/- 0.7 mmol/L, n = 11 to 4.9 +/- 1.0 mmol/L, n = 30; p = <.001). Cholesterol levels exceeded 10.0 mmol/L in 3 of 49 (6%) PI-treated children and culminated at 13.8 mmol/L. Plasma cholesterol levels in PI-treated children were comparable with levels reported for heterozygous FH children but were all lower than in homozygous FH children. Because heterozygous FH patients usually develop heart disease in middle age, the authors conclude that the risk for heart disease in PI-treated children is minimal. Long-term monitoring of these children, however, will be necessary.