The impact of HIV and antiretroviral therapy on the cardiovascular system in HIV-infected children. (360G-Wellcome-088530_Z_09_Z)

HIV and some antiretroviral (ARV) drugs are associated with impaired cardiac and vascular function in adults, but little is known about the impact in HIV-infected children. This project will explore the relationships between HIV infection, immune activation and cardiovascular phenotype in HIV infected children living in Africa recruited to a funded pharmacokinetic study of different nucleoside reverse transcriptase inhibitors CHAPAS 3. I will make serial measurements of Carotid Intimal Media l Thickness (CIMT) and Pulse Wave Velocity (PWV) over 96 weeks in 2 HIV infected cohorts (1 70 children stable for more than 2 years on ARVs and 2 70 children about to start ARVs). Findings will be compared to HIV negative matched community controls (n=140). The primary outcome measure of my project will be differences in PWV between the 3 groups at 96 weeks. Additional measurements of vascular injury (circulating endothelial cells, endothelial microparticles and soluble vascular adhesi on molecules) and markers of immune activation (D-Dimer, Interleukin-6, high sensitivity CRP) and lipid profiles will also be made. Alongside factors such as cost, the results are likely to influence future guidelines and policy decisions on first line antiretroviral therapy in HIV-infected children worldwide.