(P24-010-24) Associations Between Fatty Acid Levels and Perinatal HIV Status and In-Utero/Peripartum Antiretroviral Therapy (IPA) Exposure Among Ugandan Children and Adolescents

Objectives: To determine if fatty acid (FA) levels differ by adolescent status and quantify the relationship between polyunsaturated fatty acid (PUFA) levels and perinatal HIV-related factors among Ugandan children and adolescents.

Methods: 243 school-aged children (6-10 years old) and 383 adolescents (11-18 years old) were recruited in Kampala. Baseline serum samples were obtained and methylated to quantify FAs using gas-chromatography mass-spectroscopy. Perinatal HIV infection/exposure and IPA exposure status were established from medical records. Descriptive statistics were used to analyze differences in FA levels by adolescent status, and multivariable linear regression analyses were performed to relate risk factors to select PUFA levels in each youth group.

Results: Adolescents had higher saturated FA (55.3% v. 43.4%) and monounsaturated FA (21.2% v. 7.2%) and lower n-6 (20.8% v. 46.4%) and n-3 (2.5% v. 2.9%) PUFA levels than children (all p < 0.05). Relative to children HIV unexposed uninfected (HUU), children with perinatal HIV infection (PHIV) had unfavorable FA levels (higher T:T ratio and Mead acid) with variations by IPA exposure type. Specifically, FA profile was worse for children PHIV with no IPA and combination ART (cART) exposure, but nevirapine+zidovudine+lamivudine (NVP+ZDV+3TC) exposure was associated with a favorable FA profile among children PHIV and children HIV exposed uninfected (HEU). Among adolescents, increasing age was associated with a more favorable FA profile. Overall, relative to adolescents HUU, adolescents PHIV had lower EPA levels, but FA levels varied further by IPA exposure type. Specifically, adolescents PHIV with no IPA exposure had lower linoleic acid and EPA levels and those with cART exposure had lower n-3 PUFA levels, but adolescent PHIV exposed to NVP±ZDV had more beneficial FA levels (all p < 0.05).

Conclusions: Adolescents are more vulnerable to low PUFA levels than children, but their levels increase with age. Overall, PHIV and HEU status are associated with low levels for some n-3 and n-6 PUFAs. However, the relationship between perinatal HIV status and FA levels varies by adolescent status and IPA exposure type. Additional studies examining the contributory role of IPA exposure type are warranted.

Funding Sources: National Institute of Neurological Disorders and Stroke of the National Institutes of Health