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Corresponding Author: Thomas J. Stac MD, MPH, 630 W 168th St, Babies and Children's Hospital, 2 North, Room 260, Columbia-Presbyterian Medical Center, New York, NY 10032

Acknowledgements: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE: Hannah Peavy, MD (Project Officer), Anthony Kalica, PhD, Elaine Sloand, MD, George Sopko, MD, MPH, Margaret Wu, PhD;

CHAIRMAN, THE STEERING COMMIT-TEE: Robert Mellins, MD; CLINICAL CEN-TERS: Baylor College of Medicine, Houston, TX: William Shearer, MD, PhD, Nancy Ayres, MD, J. Timothy Bricker, MD, Arthur Garson, MD, Linda Davis, RN, BSN, Paula Feinman, Mary Beth Mauer, RN, BSN;

University of Texas: Debra Mooneyham, RN; Teresa Tonsberg, RN; Children's Hospital/Harvard Medical School, Boston, MA: Steven Lipshultz, MD, Steven Colan, MD, Lisa Hornberger, MD, Steven Sanders, MD, Marcy Schwartz, MD, Helen Donovan, Janice Hunter, MS, RN, Ellen McAuliffe, BSN, Nandini Moorthy, Patricia Ray, BS, Sonia Sharma, BS;

Boston Medical Center: Suzanne Steinbach, MD, Karen Lewis, RN, BSN;

Mount Sinai School of Medicine, New York, NY: Meyer Kattan, MD, Wyman Lai, MD, MPH, Diane Carp, MSN, RN, Donna Lewis, Sue Mone, MS;

Beth Israel Medical Center: Mary Anne Worth, RN;

Presbyterian Hospital in the City of New York/Columbia University, New York, NY: Robert Mellins, MD, Fred Bierman, MD (through 5/91), Welton Gersony, MD, Jane Pitt, MD, Thomas Starc, MD, MPH, Anthony Brown, Margaret Challenger, Kimberly Geromanos, RN, MS, CNS;

UCLA School of Medicine, Los Angeles, CA: Samuel Kaplan, MD, Y. Al-Khatib, MD, Robin Doroshow, MD, Josephine Isabel-Jones, MD, Roberta Williams, MD, Helene Cohen, RN, PNP, Sharon Golden, RDMS, Karen Simandle, RDMS, Ah-Lin Wong, RDMS;

Children's Hospital LA, Los Angeles, CA: Arno Hohn, MD, Barry Marcus, MD, Audrey Gardner, BS, Toni Ziolkowski, RN;

LAC/USC: Lynn Fukushima, MSN, RN;

CLINICAL COORDINATING CENTER: The Cleveland Clinic Foundation, Cleveland, OH: Kirk A. Easley, MS, Michael Kutner, PhD (through 12/99), Mark Schluchter, PhD (through 04/98), Johanna Goldfarb, MD, Douglas Moodie, MD, Cindy Chen, MS, Scott Husak, BS, Victoria Konig, ART, Sunil Rao, PhD, Amrik Shah, ScD, Susan Sunkle, BA, Weihong Zhang, MS; POLICY, DATA, AND SAFETY MONITORING BOARD: Henrique Rigatto, MD (Chairman), Edward B. Clark, MD, Robert B. Cotton, MD, Vijay V. Joshi, MD, Paul S. Levy, ScD, Norman S. Talner, MD, Patricia Taylor, PhD, Robert Tepper, MD, PhD, Janet Wittes, PhD, Robert H. Yolken, MD, Peter E. Vink, MD.

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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, and NO1-HR-96043) and in part by the National Institutes of Health General Clinical Research Center Grants (RR-00865, RR-00188, RR-02172, RR-00533, RR-00071, RR-00645, RR-00685, and RR-00043).

Incidence of cardiac abnormalities in children with human immunodeficiency virus infection: The prospective P2 C2 HIV study

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Journal Title:

The Journal of Pediatrics

Volume:

Volume 141, Number 3

Publisher:

, Pages 327-335

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objective: To describe the 5-year cumulative incidence of cardiac dysfunction in human immunodeficiency virus (HIV)-infected children. Study design: We used a prospective cohort design, enrolling children at 10 hospitals. Group I included 205 vertically HIV-infected children enrolled at a median age of 1.9 years. Group II consisted of 600 HIV-exposed children enrolled prenatally or as neonates, of whom 93 were ultimately HIV-infected. The main outcome measures were echocardiographic indexes of left ventricular dysfunction. Results: In group I, the 5-year cumulative incidence of left ventricular fractional shortening ≤25% was 28.0%. The 5-year incidence of left ventricular end-diastolic dilatation was 21.7%, and heart failure and/or the use of cardiac medications 28.8%. The mortality rate 1 year after the diagnosis of heart failure was 52.5% [95% CI, 30.5-74.5]. Within group II, the 5-year cumulative incidence of decreased fractional shortening was 10.7% in the HIV-infected compared with 3.1% in the HIV-uninfected children (P =.01). Left ventricular dilation, heart failure, and/or the use of cardiac medications were more common in infected compared with uninfected children. Conclusions: During 5 years of follow-up, cardiac dysfunction occurred in 18% to 39% of HIV-infected children and was associated with an increased risk of death. We recommend that HIV-infected children undergo routine echocardiographic surveillance for cardiac abnormalities.

Copyright information:

© 2002 Published by Elsevier Inc.

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