title: Cardiac function in vertically HIV-infected children and adolescents in the era of highly active antiretroviral therapy.
abstract: BACKGROUND
  Previous studies have demonstrated increased risk of adverse cardiac outcomes in adults with HIV infection. However, few studies have addressed this problem in vertically HIV-infected children and adolescents, and the long-term cardiac health of this unique population in the antiretroviral therapy era is still unknown.
  
  
  METHODS
  Ventricular function was evaluated cross-sectionally in a group of HIV-infected children and adolescents and healthy controls, using conventional echocardiography along with tissue Doppler imaging and strain analysis by speckle tracking. Simultaneously, measurements of carotid intima-media thickness were performed.
  
  
  RESULTS
  A total of 64 cases and 58 controls were included, mean age was 13.6 ± 5.4 years and 64% were females. All but 2 patients were on antiretroviral treatment, and 64% had undetectable viral load. HIV-infected patients showed higher intima-media thickness (0.425 ± 0.019 vs. 0.415 ± 0.019 mm, P = 0.003). Statistically significant differences were found between groups in ejection fraction and fractional shortening (66.1% and 36.2% in the HIV-infected group vs. 71.5% and 40.8% in the control group, respectively, P = 0.001), although individual values fell within or near normal ranges. There were no significant differences in diastolic function, tissue Doppler imaging or cardiac strain (longitudinal and rotational) between both groups. No associations were identified between echocardiographic parameters and current CD4+ T-lymphocyte counts, CD4+ T-lymphocyte nadir, HIV viral load, duration or type of antiretroviral treatment regimens.
  
  
  CONCLUSIONS
  In a context of highly effective antiretroviral treatment, no differences were found regarding cardiac abnormalities using conventional and advanced ultrasound imaging techniques in this cohort of vertically HIV-infected children and adolescents, when compared with healthy controls.
authors: From the *Laboratorio de Inmunobiología Molecular, Hospital General Universitario Gregorio Marañón; †Instituto de Investigación Sanitaria Gregorio Marañón; ‡Unidad de Cardiología Infantil, Hospital General Universitario Gregorio Marañón; §Imaging in Experimental Cardiology Laboratory, Centro Nacional de Investigaciones Cardiovasculares Carlos III; ¶Unidad de Inmunodeficiencias, Servicio de Pediatría, Hospital Universitario Doce de Octubre; ‖Servicio de Pediatría, Hospital Universitario La Paz; **Servicio de Pediatría, Hospital de Getafe; ††Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital General Universitario Gregorio Marañón; ‡‡Servicio de Pediatría, Hospital Universitario Niño Jesús; and §§Servicio de Pediatría, Hospital Carlos III and Servicio de Pediatría, Hospital La Paz, Madrid, Spain.
authors: Talía
authors: T
authors: Sainz
authors: María
authors: M
authors: Álvarez-Fuente
authors: Rodrigo
authors: R
authors: Fernández-Jiménez
authors: María Isabel
authors: MI
authors: González-Tomé
authors: María Isabel
authors: MI
authors: de José
authors: José Tomás
authors: JT
authors: Ramos
authors: María Luisa
authors: ML
authors: Navarro
authors: Jorge
authors: J
authors: Martínez
authors: Milagros
authors: M
authors: García-Hortelano
authors: Constancio
authors: C
authors: Medrano
authors: María Ángeles
authors: MÁ
authors: Muñoz-Fernández
authors: María José
authors: MJ
authors: Mellado
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D059168:Carotid Intima-Media Thickness; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology* / Q000635:transmission; D006334:Heart Function Tests; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents