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Author Notes:

Address for correspondence: Dr. Wyman W. Lai, Division of Pediatric Cardiology, Box 1201, The Mount Sinai Medical Center, One Gustave L. Levy Place, New York, New York 10029-6574. Email: Wyman_Lai@smtplink.mssm.edu

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Research Funding:

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).

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

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Journal Title:

Journal of the American College of Cardiology

Volume:

Volume 32, Number 6

Publisher:

, Pages 1749-1755

Type of Work:

Article | Post-print: After Peer Review

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.

Copyright information:

© 1998 American College of Cardiology.

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