Incidence of cardiac abnormalities in children with human immunodeficiency virus infection: The prospective P2C2 HIV study

Thomas J. Starc, Steven E. Lipshultz, Kirk A. Easley, Samuel Kaplan, J. Timothy Bricker, Steven D. Colan, Wyman W. Lai, Welton M. Gersony, George Sopko, Douglas S. Moodie, Mark D. Schluchter

Research output: Contribution to journalArticle

61 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)327-335
Number of pages9
JournalJournal of Pediatrics
Volume141
Issue number3
DOIs
StatePublished - Sep 2002

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Starc, T. J., Lipshultz, S. E., Easley, K. A., Kaplan, S., Bricker, J. T., Colan, S. D., Lai, W. W., Gersony, W. M., Sopko, G., Moodie, D. S., & Schluchter, M. D. (2002). Incidence of cardiac abnormalities in children with human immunodeficiency virus infection: The prospective P2C2 HIV study. Journal of Pediatrics, 141(3), 327-335. https://doi.org/10.1067/mpd.2002.126301