Changes in the lipidome are associated with immune activation and subclinical vascular disease in youth with HIV in Uganda

This study examined the changes in the lipidome and associations with immune activation and cardiovascular disease (CVD) markers in youth with perinatally acquired human immunodeficiency virus (YPHIV). The serum lipidome was measured in antiretroviral therapy (ART)-treated YPHIV (n = 100) and human immunodeficiency virus-uninfected children (n = 98) in Uganda. Plasma markers of systemic inflammation, monocyte activation, gut integrity, and T-cell activation, as well as common carotid artery intima media thickness and pulse wave velocity (PWV), were evaluated at baseline and 96 weeks. Overall, median age was 12 years, and 52% were females. Total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein were similar between the groups; however, the concentrations of ceramides, diacylglycerols, free fatty acids, lysophosphatidylcholines, and phosphatidylcholines were higher in YPHIV (P ≤ .03). Increases in phosphatidylethanolamine (16:0 and 18:0) correlated with increases in soluble CD163, oxidized LDL, C-reactive protein, intestinal fatty acid binding protein, and PWV in YPHIV (r ≥ 0.3). YPHIV successfully suppressed on ART have elevated lipid species that are associated with CVD, specifically palmitic acid (C16:0) and stearic acid (C18:0).