Cardiovascular status of infants and children of women infected with HIV-1 (P(2)C(2) HIV): a cohort study.
BACKGROUND
Data from cross-sectional and short-term longitudinal studies have suggested that children infected with HIV-1 might have cardiovascular abnormalities. We aimed to investigate this hypothesis in a long-term cohort study.


METHODS
We measured cardiovascular function every 4-6 months for up to 5 years in a birth cohort of 600 infants born to women infected with HIV-1. We included 93 infants infected with HIV-1 and 463 uninfected infants (internal controls) from the same cohort. We also included a cross-sectionally measured comparison group of 195 healthy children born to mothers who were not infected with HIV-1 (external controls).


RESULTS
Children infected with HIV-1 had a significantly higher heart rate at all ages (mean difference 10 bpm, 95% CI 8-13) than internal controls. At birth, both cohort groups of children had similar low left ventricular (LV) fractional shortening. At 8 months, fractional shortening was similar in internal and external controls, whereas in children infected with HIV-1, fractional shortening remained significantly lower than in controls for the first 20 months of life (mean difference from internal controls at 8 months 3.7%, 2.3-5.1). LV mass was similar at birth in both cohort groups, but became significantly higher in children with HIV-1 from 4-30 months (mean difference 2.4 g at 8 months, 0.9-3.9).


CONCLUSIONS
Vertically-transmitted HIV-1 infection is associated with persistent cardiovascular abnormalities identifiable shortly after birth. Irrespective of their HIV-1 status, infants born to women infected with HIV-1 have significantly worse cardiac function than other infants, suggesting that the uterine environment has an important role in postnatal cardiovascular abnormalities.
Lipshultz
Steven E
SE
Division of Pediatric Cardiology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
Easley
Kirk A
KA
Orav
E John
EJ
Kaplan
Samuel
S
Starc
Thomas J
TJ
Bricker
J Timothy
JT
Lai
Wyman W
WW
Moodie
Douglas S
DS
Sopko
George
G
Schluchter
Mark D
MD
Colan
Steven D
SD
D018376:Cardiovascular Abnormalities / Q000209:etiology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000635:transmission*; D015497:HIV-1; D006339:Heart Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D014481:United States