Associations between perinatal HIV-related risk factors and select serum polyunsaturated fatty acid (PUFA) levels among Ugandan children and adolescents.

Abstract

Objective: To (1) determine how serum fatty acid (FA) levels differ by developmental stage, (2) quantify associations between perinatal HIV-related factors and polyunsaturated fatty acid (PUFA) levels, and (3) examine the heterogeneity of these associations by developmental stage.

Design: Cross-sectional secondary analysis of baseline data from two prospective cohorts.

Setting: Kampala, Uganda.

Participants: 243 children (6-10-years old) and 383 adolescents (11-18-years old) were recruited at Kawaala Health Center based on perinatal HIV status. Youth (children and adolescents) were classified as: those with perinatal HIV infection (PHIV: n=212), those perinatally HIV exposed but remained uninfected (HEU: n=211), and those perinatally HIV unexposed and uninfected (HUU: n=203).

Results: Adolescents had lower n-6 and n-3 PUFA levels than children, and among adolescents, these levels increased with age. Relative to children HUU, children PHIV had a higher triene:tetraene ratio and 20:3n-9 (indicators of essential fatty acid deficiency (EFAD)). Adolescents PHIV vs. HUU had lower 20:5n-3 levels. When considering in-utero/peripartum antiretroviral therapy (IPA) exposure, FA profile was indicative of EFAD for youth PHIV with a) no IPA exposure and b) combination IPA exposure, whereas non-nucleoside reverse transcriptase inhibitor+nucleoside reverse transcriptase inhibitor exposure was associated with a favorable FA profile among youth PHIV and HEU (all p < 0.05).

Conclusion: In this sample, perinatal HIV status was associated with low PUFA levels, and these associations varied by developmental stage and IPA exposure type. Future research should elucidate the contribution of IPA exposure type to EFAD and the implications of these differences on growth and cognitive development.