Cardiac morbidity and related mortality in children with HIV infection

Lynn M. Luginbuhl, E. John Orav, Kenneth McIntosh, Steven E Lipshultz

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Objective. - Dysmythmias, hemodynamic instability, congestive heart failure, and sudden death are serious complications of human immunodeficiency virus (HIV) infection that, to our knowledge, have not been studied systematically. We sought to determine the cumulative incidence and clinical predictors of these adverse events in a cohort of HIV-infected children. Design. - Historical cohort study. Setting. - University-affiliated, primary and tertiary care pediatric hospital and ambulatory care center. Participants. - Eighty-one HIV-infected children who had one or more cardiac evaluations between 1984 and 1991 form the study cohort. The initial cardiac evaluation occurred at a median age of 1.5 years, and children were followed up to a median age of 3.6 years. Main Outcome Measures. - Mortality (related to cardiac dysfunction as well as noncardiac causes), tachycardia, bradycardia, hypertension, hypotension, marked sinus arrhythmia, cardiac arrest, and chronic congestive heart failure. Results. - Hemodynamic abnormalities and dysrhythmias occurred frequently. Eight unexpected cardiorespiratory arrests occurred in seven children (9%). Chronic congestive heart failure was noted in 10% of patients. Thirty children died, 10 with significant cardiac dysfunction. As HIV-infected children progressed from acquired immunodeficiency syndrome (AIDS)-related complex to AIDS, significant cardiac problems were more likely to occur. Both nonneurologic AIDS and encephalopathy were strongly associated with most severe cardiac outcomes. However, encephalopathy was the strongest correlate of cardiorespiratory arrest (P=.002). Epstein-Barr virus confection was the strongest correlate of chronic congestive heart failure (P<.001). Conclusions. - Cardiac morbidity and mortality are more common with advanced HIV infection. The presence of encephalopathy or Epstein-Barr virus coinfection identifies HIV-infected children at especially high risk for adverse cardiac outcomes.

Original languageEnglish
Pages (from-to)2869-2875
Number of pages7
JournalJournal of the American Medical Association
Volume269
Issue number22
StatePublished - Dec 1 1993
Externally publishedYes

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Child Mortality
Virus Diseases
HIV
Morbidity
Brain Diseases
Heart Failure
Acquired Immunodeficiency Syndrome
Human Herpesvirus 4
Cohort Studies
Hemodynamics
Candy
Sinus Arrhythmia
Pediatric Hospitals
Mortality
Tertiary Healthcare
Bradycardia
Ambulatory Care
Sudden Death
Heart Arrest
Coinfection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Luginbuhl, L. M., Orav, E. J., McIntosh, K., & Lipshultz, S. E. (1993). Cardiac morbidity and related mortality in children with HIV infection. Journal of the American Medical Association, 269(22), 2869-2875.

Cardiac morbidity and related mortality in children with HIV infection. / Luginbuhl, Lynn M.; Orav, E. John; McIntosh, Kenneth; Lipshultz, Steven E.

In: Journal of the American Medical Association, Vol. 269, No. 22, 01.12.1993, p. 2869-2875.

Research output: Contribution to journalArticle

Luginbuhl, LM, Orav, EJ, McIntosh, K & Lipshultz, SE 1993, 'Cardiac morbidity and related mortality in children with HIV infection', Journal of the American Medical Association, vol. 269, no. 22, pp. 2869-2875.
Luginbuhl LM, Orav EJ, McIntosh K, Lipshultz SE. Cardiac morbidity and related mortality in children with HIV infection. Journal of the American Medical Association. 1993 Dec 1;269(22):2869-2875.
Luginbuhl, Lynn M. ; Orav, E. John ; McIntosh, Kenneth ; Lipshultz, Steven E. / Cardiac morbidity and related mortality in children with HIV infection. In: Journal of the American Medical Association. 1993 ; Vol. 269, No. 22. pp. 2869-2875.
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