Howard Levitt, MD¹, Rosalind J. Carter, PhD², Eileen Rillamas-Sun, MPH², Lisa G Robinson, MD¹, Susan Champion, MD¹, and Elaine J. Abrams, MD¹. (1) Harlem Hospital Center, 506 Lenox Ave, New York, NY 10037, (2) Medical and Health Research Association of New York City, Inc., 40 Worth St., Room 706, New York, NY 10013, 212-233-9366, rjcarter@optonline.net

Background: While HAART therapy has improved survival among HIV-infected children, adverse side effects, including hypercholesterolemia, may put children at risk for cardiovascular events. Methods: Serum total cholesterol levels were abstracted from medical charts of a cohort of 113 perinatally HIV-infected children followed for routine care at an urban hospital from October 2000 through January 2002. Differences in mean cholesterol were analyzed using t-test and ANOVA. Chi-square and odds ratios (OR) were calculated for categorical outcomes. Results: The prevalence of hypercholesterolemia (HC), defined as serum cholesterol >200 mg/dL, was 20%. The mean age of this cohort was 8.6 years (range: 0-19); 54% were male. At first cholesterol measurement, 51 (45%) were on a PI regimen for a mean duration of 22 months (range 2-48). Children on PI regimens had a significantly higher mean cholesterol (180 mg/dL; 95% CI: 168-192) than children on non-PI regimens (153 mg/dL; 95% CI: 142-165) and children who were not currently receiving ART (147mg/dL; 95% CI: 124-169; F=7.1 p<.001). Mean cholesterol was higher among children with PI duration > 6 m (180 mg/dL) vs. <6 m (130 mg/dL) although this difference was not statistically significant (p=.07). The prevalence of HC was higher among children on PI vs. non-PI regimens [16/51 vs. 4/41; OR=4.2; 95% CI 1.2-18.8]. HC was not associated with age, sex, viral load, or BMI. Conclusions: Children on PIs are at higher risk of clinically significant hyperlipidemia. Because the long term consequences of hyperlipidemia are unknown, children on PIs should be monitored closely.

Learning Objectives:

• Attendees will be able to understand the adverse metabolic events associated with specific pediatric HIV regimens

Keywords: HIV/AIDS, Children and Adolescents

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.