Cardiac biomarkers in HIV-exposed uninfected children

James D. Wilkinson, Paige L. Williams, Erin Leister, Bret Zeldow, William T. Shearer, Steven D. Colan, George K. Siberry, Laurie B. Dooley, Gwendolyn B Scott, Kenneth C. Rich, Steven E Lipshultz

Research output: Contribution to journalArticle

16 Citations (Scopus)


Objectives: To evaluate associations of cardiac biomarkers with in-utero antiretroviral drug exposures and cardiac function/structure measured by echocardiograms in HIV-exposed but uninfected (HEU) children. Design and methods: We analyzed the association of three cardiac biomarkers (cardiac troponin T, cTnT; high sensitivity C-reactive protein, hsCRP; and N-terminal pro-brain natriuretic peptide, NT-proBNP) with prenatal antiretroviral drug exposures, maternalchild characteristics, and echocardiographic parameters. Results: Among 338 HEU children (mean age 4.3 years), 51% had at least one elevated cardiac biomarker. Maternal tobacco use was associated with elevated NT-proBNP [adjusted odds ratio (aOR) 2.28, P=0.02]. Maternal alcohol and abacavir use were associated with elevated cTnT levels (aOR 3.56, P=0.01 and aOR 2.33, P=0.04, respectively). Among 94 children with paired echocardiogram- biomarker measurements, cTnT measurements were correlated with increased left-ventricular thickness-to-dimension ratio (r=0.21, P=0.04); and elevated cTnT was associated with higher mean left-ventricular end-diastolic (LVED) posterior wall thickness (P=0.04). hsCRP measurements were negatively correlated with septal thickness (r=- 0.22, P=0.03) and elevated hsCRP was associated with lower mean left-ventricular contractility Z-scores (P=0.04). NT-proBNP measurements were correlated with increased LVED dimension (r = 0.20, P=0.05) and elevated NT-proBNP was associated with lower mean end-systolic septal thickness (P=0.03). Conclusion: Our findings suggest that cardiac biomarkers may help identify HEU children who require further cardiac evaluation including echocardiography. Potential cardiac effects of prenatal abacavir exposure in this population need further investigation.

Original languageEnglish
Pages (from-to)1099-1108
Number of pages10
Issue number7
StatePublished - Apr 24 2013


Odds Ratio
Troponin T
Brain Natriuretic Peptide
Tobacco Use
Pharmaceutical Preparations
C-Reactive Protein
pro-brain natriuretic peptide (1-76)


  • Antiretroviral drugs
  • Cardiac biomarkers
  • Echocardiography
  • HIV
  • Pediatric

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Wilkinson, J. D., Williams, P. L., Leister, E., Zeldow, B., Shearer, W. T., Colan, S. D., ... Lipshultz, S. E. (2013). Cardiac biomarkers in HIV-exposed uninfected children. AIDS, 27(7), 1099-1108.

Cardiac biomarkers in HIV-exposed uninfected children. / Wilkinson, James D.; Williams, Paige L.; Leister, Erin; Zeldow, Bret; Shearer, William T.; Colan, Steven D.; Siberry, George K.; Dooley, Laurie B.; Scott, Gwendolyn B; Rich, Kenneth C.; Lipshultz, Steven E.

In: AIDS, Vol. 27, No. 7, 24.04.2013, p. 1099-1108.

Research output: Contribution to journalArticle

Wilkinson, JD, Williams, PL, Leister, E, Zeldow, B, Shearer, WT, Colan, SD, Siberry, GK, Dooley, LB, Scott, GB, Rich, KC & Lipshultz, SE 2013, 'Cardiac biomarkers in HIV-exposed uninfected children', AIDS, vol. 27, no. 7, pp. 1099-1108.
Wilkinson JD, Williams PL, Leister E, Zeldow B, Shearer WT, Colan SD et al. Cardiac biomarkers in HIV-exposed uninfected children. AIDS. 2013 Apr 24;27(7):1099-1108.
Wilkinson, James D. ; Williams, Paige L. ; Leister, Erin ; Zeldow, Bret ; Shearer, William T. ; Colan, Steven D. ; Siberry, George K. ; Dooley, Laurie B. ; Scott, Gwendolyn B ; Rich, Kenneth C. ; Lipshultz, Steven E. / Cardiac biomarkers in HIV-exposed uninfected children. In: AIDS. 2013 ; Vol. 27, No. 7. pp. 1099-1108.
title = "Cardiac biomarkers in HIV-exposed uninfected children",
abstract = "Lippincott Williams & Wilkins.",
keywords = "Antiretroviral drugs, Cardiac biomarkers, Echocardiography, HIV, Pediatric",
author = "Wilkinson, {James D.} and Williams, {Paige L.} and Erin Leister and Bret Zeldow and Shearer, {William T.} and Colan, {Steven D.} and Siberry, {George K.} and Dooley, {Laurie B.} and Scott, {Gwendolyn B} and Rich, {Kenneth C.} and Lipshultz, {Steven E}",
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journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
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