Risk factors associated with adverse metabolic health in youth with perinatally acquired HIV living in the United Kingdom.

OBJECTIVE

Non-AIDS-related morbidity and mortality in people with HIV are associated with adverse metabolic health, influenced by both traditional-related and HIV-related risk factors. There is a paucity of data for youth with perinatal HIV (PHIV). We explored the relationship between markers of metabolic health and antiretroviral therapy (ART) in youth with PHIV.

DESIGN

Longitudinal observational cohort study; 26 months.

METHODS

Eighty-five youth enrolled in the 'Bone Density in Youth living with PHIV' (BONDY) underwent assessment of metabolic health including fasting biochemistry, BMI, total body dual energy x-ray absorptiometry scan and hepatic transient elastography.

RESULTS

Of 85 participants with PHIV, mean age 21.7 years, 58% were female and 82% black African. Median ART exposure was 15 years, median CD4 + cell count 623 cells/μl at enrolment with 82% viral load less than 200 copies/ml. Median weight gain over 26 months was 3 kg, with BMI category overweight/obese increasing from 37 to 50% with 48% having dyslipidaemia. Metabolic syndrome criteria were fulfilled in 7%, with 13% having hypertension, 18% hepatic steatosis, and 7% fibrosis on transient elastography. Bayesian regression analyses demonstrated no association of integrase strand transfer inhibitor (INSTI) and/or tenofovir alafenamide (TAF) use, and sex at birth or prior CDC-C diagnoses or current HIV viraemia on metabolic outcomes.

CONCLUSION

While adverse metabolic outcomes are common in this youth cohort with PHIV, no association was observed with INSTI and/or TAF use. Given the relatively young age of this cohort, preventative interventions targeting traditional metabolic risk factors are required to avoid comorbidities in later life.