Association of Perinatal HIV Exposure and HIV Disease Severity With BP in Youth.

backgroundHIV infection is associated with cardiovascular events in adults. We compared mean blood pressure (BP) obtained at study visits between youth with/without perinatally acquired HIV infection and evaluated whether HIV disease severity was associated with BP.

methodsBP was compared between participants with/without HIV in the Adolescent Master Protocol of the Pediatric HIV/AIDS Cohort Study. Marginal repeated measures analyses using generalized estimating equations evaluated the association of HIV disease severity with BP index (mean BP/95th percentile BP) and abnormal BP.

results447 youth with HIV and 226 youth without HIV were included. Youth with HIV were more often Black non-Hispanic (66% versus 54%), had greater household income (54% versus 35%), and lower measures of adiposity than those without. Systolic BP was similar between groups, but mean diastolic BP was lower for preadolescents (63.3 mm Hg [95% CI, 59.0-67.0] versus 65.0 [61.5-68.7]) with HIV. Although youth with HIV had lower diastolic BP index (-0.011 [95% CI, -0.021 to -0.001]) and lower prevalence of abnormal BP (odds ratio, 0.78 [95% CI, 0.62-0.97]) at study visits in initial adjusted models, these associations were attenuated after adjustment for body mass index (-0.007 [95% CI, -0.017 to 0.003], odds ratio, 0.94 [95% CI, 0.76, 1.17], respectively). HIV disease severity was not associated with systolic or diastolic BP.

conclusionsYouth with HIV had lower adiposity and BP than youth without HIV during study visits. Although youth with HIV had a lower risk of abnormal BP, this association did not persist after adjustment for adiposity. Prevention and treatment of other traditional cardiovascular disease risk factors remain important among youth living with HIV.