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[Cardiovascular morbidity in children with human immunodeficiency virus infection]
G Nogueira1, A J Macedo, A Paixão
1Serviço de Cardiologia Pediátria, Hospital de Santa Marta, Lisboa.
Insights
Cardiovascular abnormalities are common in children with human immunodeficiency virus (HIV). Pulmonary hypertension and left ventricular dysfunction were most frequent, highlighting the need for cardiac monitoring in pediatric HIV patients.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Medicine
Context:
- Cardiovascular abnormalities are increasingly recognized in children with human immunodeficiency virus (HIV) infection.
- Understanding the prevalence and predictors of these conditions is crucial for timely intervention.
Purpose:
- To evaluate the occurrence and clinical predictors of cardiovascular abnormalities in a cohort of HIV-infected children.
- To identify specific cardiac conditions and associated factors in this pediatric population.
Summary:
- A study of 32 HIV-infected children (mean age 3.11 years) revealed cardiovascular abnormalities in 47% of cases.
- Pulmonary hypertension (34%) and left ventricular dysfunction (13%) were the most prevalent findings.
- Sinus tachycardia was observed in 44% of patients, with heart rates exceeding the 95th percentile.
Impact:
- Cardiovascular abnormalities, particularly pulmonary hypertension, are frequent in children with advanced HIV-1 infection.
- Findings suggest a link between pulmonary hypertension and respiratory disease in HIV-infected children.
- Regular cardiological follow-up is recommended for all children with HIV infection.
Unlabelled:
Abnormalities of cardiovascular structure and function have been described among children with human immunodeficiency virus (HIV). In order to evaluate their occurrence and clinical predictors, 32 children infected with HIV, aged three months to 13 years (mean age = 3.11 +/- 3.51 years) were studied. Perinatal transmission was identified in 90% of the children. Twenty-two patients (pts) (69%) had symptoms, nine being moderately symptomatic and eight severely symptomatic. Fourteen pts had immunological disturbances and eight of them were severely immunosuppressed. Twenty-eight pts (88%) had HIV-1 infection and 6 recent Ebstein-Barr virus coinfection. Nineteen were on zidovudine and 14 on intravenous immunoglobulin treatment. Nineteen cardiovascular abnormalities were found in 15 pts (47%): 11 cases of pulmonary hypertension by echocardiographic criteria (eight of them had interstitial lung infiltrates seen on chest X-ray) and four cases of left ventricular dysfunction requiring anticongestive therapy. Other abnormalities were: patent ductus arteriosus, septal hypertrophy, mitral valve prolapse and pericardial effusion (one case each). Surface ECG displayed right ventricular hypertrophy in four pts, left ventricular hypertrophy in one patient and unspecific ST-T wave changes in two pts. Fourteen pts (44%) had sinus tachycardia with mean heart rate above the 95th percentile on 24-hour Holter monitoring.
Conclusions:
Cardiovascular abnormalities are frequent among children with HIV-1 infection in late stages; pulmonary hypertension is the most frequently found cardiovascular anomaly and seems to be related to either chronic or recurrent respiratory disease; cardiological follow-up is recommended for HIV-infected children.