title: Cardiovascular status of infants and children of women infected with HIV-1 (P(2)C(2) HIV): a cohort study.
abstract: 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.
authors.affiliation: Division of Pediatric Cardiology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
authors.forename: Steven E
authors.initials: SE
authors.lastname: Lipshultz
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Easley
authors.forename: E John
authors.initials: EJ
authors.lastname: Orav
authors.forename: Samuel
authors.initials: S
authors.lastname: Kaplan
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Starc
authors.forename: J Timothy
authors.initials: JT
authors.lastname: Bricker
authors.forename: Wyman W
authors.initials: WW
authors.lastname: Lai
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Moodie
authors.forename: George
authors.initials: G
authors.lastname: Sopko
authors.forename: Mark D
authors.initials: MD
authors.lastname: Schluchter
authors.forename: Steven D
authors.initials: SD
authors.lastname: Colan
mesh_terms: 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