title: Cardiovascular outcomes of pediatric seroreverters perinatally exposed to HAART: design of a longitudinal clinical study.
abstract: Seroreverters (uninfected children of HIV-infected mothers) have exhibited left ventricular (LV) dysfunction. Mitochondrial toxicity associated with in utero or postnatal exposure to highly active antiretroviral therapy (HAART) is a possible mechanism. Adult and animal models have demonstrated associations between LV abnormalities, cardiomyopathy, and components of HAART. Yet, outcomes in children are poorly understood. In this study, we explore HAART-associated LV abnormalities in seroreverters exposed to HAART (n = 144) or never exposed (n = 252). Subjects are drawn from the Women and Infants Transmission Study and the Pediatric Pulmonary and Cardiovascular Complications of HIV Study, respectively. Data include (1) echocardiographic studies of LV structure and function and (2) serologic cardiac biomarkers (cardiac troponin, probrain natriuretic peptide, high-sensitivity C reactive protein), both collected during the first month of life, and again at 6, 12, 24, 36, and 48 months postnatally. Planned analyses include several regression models. At this time, we have access to data for all 252 unexposed children, and 53 exposed subjects are enrolled. The cohorts are similar in terms of gender and race and the recruited subjects are representative of all eligible subjects in terms of exposure to HAART. Recruitment will continue into 2006.
authors.affiliation: University of Rochester, Rochester, NY, USA.
authors.forename: Jill E
authors.initials: JE
authors.lastname: Lavigne
authors.forename: William T
authors.initials: WT
authors.lastname: Shearer
authors.forename: Bruce
authors.initials: B
authors.lastname: Thompson
authors.forename: E John
authors.initials: EJ
authors.lastname: Orav
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Starc
authors.forename: Steven D
authors.initials: SD
authors.lastname: Colan
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pignatelli
authors.forename: Sharon E
authors.initials: SE
authors.lastname: O'Brien
authors.forename: Louis
authors.initials: L
authors.lastname: Bezold
authors.forename: Phillip
authors.initials: P
authors.lastname: LaRusa
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Easley
authors.forename: Irene
authors.initials: I
authors.lastname: Cheng
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Duffy
authors.forename: Steven E
authors.initials: SE
authors.lastname: Lipshultz
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission; D018023:HIV Seronegativity; D006331:Heart Diseases / Q000139:chemically induced* / Q000196:embryology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000503:physiopathology
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers