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Author Notes:

Correspondence to: Dr Steven E Lipshultz, Division of Pediatric Cardiology, University of Rochester Medical Center, 601 Elmwood Ave, Box 631, Rochester, NY 14642, USA (steve_lipshultz@urmc.rochester.edu).

All authors helped conceive and design the study, draft and revise the manuscript, analyse and interpret data, obtain funding, and provide administrative, technical, or material support.

S Lipshultz, S Kaplan, T Starc, T Bricker, W Lai, and S Colan obtained data.

K Easley, E Orav, and M Schluchter provided statistical help.

Conflict of interest statement: None declared.

Subjects:

Research Funding:

Supported by the National Heart, Lung, and Blood Institute (NO1-HR-96037, NO1-HR-96038, NO1-HR-96039, NO1-HR-96040, NO1-HR-96041, NO1-HR-96042, NO1-HR-96043) and in part by the US National Institutes of Health (RR-00865, RR-00188, RR-02172, RR-00533, RR-00071, RR-00645, RR-00685, RR-00043).

Keywords:

  • Cardiology
  • Pediatrics

Cardiovascular status of infants and children of women infected with HIV-1 (P2C2 HIV): a cohort study

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Journal Title:

Lancet

Volume:

Volume 360, Number 9330

Publisher:

, Pages 368-373

Type of Work:

Article | Post-print: After Peer Review

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). Findings: 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.

Copyright information:

© 2002 Elsevier Ltd. All rights reserved.

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