Metabolic syndrome and Pathobiological Determination of Atherosclerosis in Youth risk score in adolescents with and without perinatally acquired HIV in the Cape Town Adolescent and Antiretroviral Cohort (CTAAC)-Heart study.

Abstract

Background: Limited data exist describing metabolic syndrome (MetS) and Pathobiological Determinants of Atherosclerosis in Youth (PDAY) coronary arteries (CA) and abdominal aorta (AA) risk scores in youth with HIV in sub-Saharan Africa.

Methods: This cross-sectional analysis assessed MetS and PDAY CA and AA risk scores among youth with perinatally acquired HIV, youth with non-perinatally acquired HIV, and HIV-seronegative youth. Elevated PDAY score was defined as ≥1. Cluster heat map analysis was used, and logistic regression models were fit to assess the association of HIV status with MetS and PDAY CA and AA risk scores separately after adjusting for covariates.

Results: We enrolled 237 youth with perinatally acquired HIV, 56 youth with non-perinatally acquired HIV and 71 HIV-seronegative youth; median (interquartile range = IQR) age was 18 (17, 20) years, 58% females. Youth with non-perinatally acquired HIV had the highest proportion with MetS (34%), while HIV-seronegative youth had 23%, and youth with perinatally acquired HIV 12%. Forty-seven percent of youth with perinatally acquired HIV, 63% of youth with non-perinatally acquired HIV and 41% of HIV-seronegative youth had elevated PDAY CA score; 30% of youth with perinatally acquired HIV, 39% of youth with non-perinatally acquired HIV and 23% of HIV-seronegative youth had elevated PDAY AA score. A non-overweight but hyperlipidaemic phenotype predominantly comprised of youth with perinatally acquired HIV was observed by cluster analysis. Youth with perinatally acquired HIV had lower adjusted odds of MetS compared with HIV-seronegative youth (odds ratio = 0.35, 95% confidence interval: 0.16, 0.79) but HIV status (either youth with perinatally acquired HIV or youth with non-perinatally acquired HIV vs. HIV-seronegative) was not associated with an elevated PDAY CA or AA risk score.

Conclusion: Youth with perinatally acquired HIV have a lower odd of MetS, reflecting an overall non-overweight, but hyperlipidaemic phenotype highlighting the need for further cardiometabolic research in this ageing population in South Africa.