Prevalence of congenital cardiovascular malformations in children of human immunodeficiency virus-infected women.

• Type of Material: Article
• Authors: Wyman W. Lai, Mount Sinai School of Medicine; Steven E. Lipshultz, Harvard University; Kirk Easley, Emory University; Thomas J. Starc, Columbia University; Stacey E. Drant, University of California Los Angeles; J. Timothy Bricker, Baylor College; Steven D. Colan, Harvard University; Douglas S. Moodie, Cleveland Clinic Foundation; George Sopko, National Heart, Lung, and Blood Institute; Samuel Kaplan, University of California Los Angeles
• Language: English
• Date: 1998-11-15
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 1998 American College of Cardiology.
• Final Published Version (URL): http://dx.doi.org/10.1016/S0735-1097(98)00449-5
• Title of Journal or Parent Work: Journal of the American College of Cardiology
• ISSN: 0735-1097
• Volume: 32
• Issue: 6
• Start Page: 1749
• End Page: 1755
• Grant/Funding Information: This work was supported by the National Heart, Lung, and Blood Institute (N01-HR-96037, NO1-HR-96038, NO1-HR-96039, NO1-HR-06040, NO1-HR-96041, NO1-HR-96042, NO1-HR-96043) and in part by the National Institutes of Health (RR-00865, RR-00188, RR-02172, RR-00533).
• Research Categories: Health Sciences, General; Health Sciences, Immunology

Abstract

Objectives. The purpose of the study was to assess the effects of maternal HIV-1 (human immunodeficiency virus) infection and vertically transmitted HIV-1 infection on the prevalence of congenital cardiovascular malformations in children. Background. In the United States, an estimated 7000 children are born to HIV-infected women annually. Previous limited reports have suggested an increase in the prevalence of congenital cardiovascular malformations in vertically transmitted HIV-infected children. Methods. In a prospective longitudinal multicenter study, diagnostic echocardiograms were performed at 4–6-month intervals on two cohorts of children exposed to maternal HIV-1 infection: 1) a Neonatal Cohort of 90 HIV-infected, 449 HIV-uninfected and 19 HIV-indeterminate children; and 2) an Older HIV-Infected Cohort of 201 children with vertically transmitted HIV-1 infection recruited after 28 days of age. Results. In the Neonatal Cohort, 36 lesions were seen in 36 patients, yielding an overall congenital cardiovascular malformation prevalence of 6.5% (36/558), with a 8.9% (8/90) prevalence in HIV-infected children and a 5.6% (25/449) prevalence in HIV-uninfected children. Two children (2/558, 0.4%) had cyanotic lesions. In the Older HIV-Infected Cohort, there was a congenital cardiovascular malformation prevalence of 7.5% (15/201). The distribution of lesions did not differ significantly between the groups. Conclusions. There was no statistically significant difference in congenital cardiovascular malformation prevalence in HIV-infected versus HIV-uninfected children born to HIV-infected women. With the use of early screening echocardiography, rates of congenital cardiovascular malformations in both the HIV-infected and HIV-uninfected children were five- to ten-fold higher than rates reported in population-based epidemiologic studies but not higher than in normal populations similarly screened. Potentially important subclinical congenital cardiovascular malformations were detected.