Paper # 889 
Associations of Pro-inflammatory Cytokine Levels with Lipid Profiles, Growth, and Body Composition in HIV-infected Children Initiating or Changing ART
J Cervia1, C Chantry2, M Hughes3, Carmelita Alvero*3, W Meyer4, J Hodge5, P Borum6, J Moye7, S Spector8, and P1010 Study Team
1Albert Einstein Coll of Med, Bronx, NY, US; 2Univ of California, Davis Med Ctr, Sacramento, US; 3Ctr for Biostatistics in AIDS Res, Harvard Sch of Publ Hlth, Boston, MA, US; 4Quest Diagnostics, Baltimore, MD, US; 5Frontier Sci and Tech Res Fndn, Amherst, NY, US; 6Univ of Florida, Gainesville, US; 7Natl Inst of Child Hlth and Human Devt, NIH, Bethesda, MD, US; and 8Univ of California, San Diego, US
Objectives: To measure pro-inflammatory cytokines
(PIC) in HIV-infected children beginning or changing antiretroviral therapy
(ART), evaluating associations with virologic, immunologic, serum lipid,
growth, and body composition measures, markers of growth hormone action and
glucose metabolism.
Methods: Forty-nine pre-pubertal HIV-infected
children had measurements of viral load (VL), CD4+, and percentage,
serum lipids, apolipoprotein A, IGF-1, IGFBP-1 and 3, anthropometry,
bioelectrical impedance analysis, TNF-alpha, IL-1 beta, and IL-6 at baseline
and 48 weeks of ART.
Results: Baseline levels were detectable (>0.1
pg/mL) for IL-1 beta in 28 of 48, and for TNF-alpha and Il-6 in all 49
children. IL-6 and TNF-alpha decreased with ART (P =0.065 and P <0.001,
respectively). Children with 48 week VL<400 copies/mL had greater declines
in TNF-alpha (mean 45%) than subjects with higher VL (5%; P =0.009).
Each 10% improvement in CD4% was associated with 26% lower TNF-alpha (P =0.002)
and 31% lower IL-6 (P =0.016). Greater reductions in TNF-alpha were
associated with lower total/HDL ratio (P =0.003) at week 48.
Conclusions: In HIV-infected children initiating or
changing ART, PIC were detectable at baseline and decreased over 48 weeks.
Better immunologic responses were associated with greater reductions in
TNF-alpha and IL-6. Reductions in TNF-alpha were associated with improved lipid
profile reflected in total/HDL cholesterol.
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