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Humanized NOG Mice for Intravaginal HIV Exposure and Treatment of HIV Infection
Published on: January 31, 2020
[Cardiac longitudinal study of children perinatally exposed to human immunodeficiency virus type 1]
Maria Suely Bezerra Diógenes1, Regina Célia de Menezes Succi, Daisy M Machado
1Universidade Federal de São Paulo, Rua Pascal 605/82, 04616-002 São Paulo, SP. mdiogenes@cardiol.br
Insights
Cardiac abnormalities are common in HIV-infected children, particularly those with advanced disease. Electrocardiogram changes were more frequent than clinical or echocardiographic findings in this pediatric HIV cohort.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Clinical Electrophysiology
Context:
- Perinatal exposure to Human Immunodeficiency Virus type 1 (HIV-1) can lead to various health complications in children.
- Cardiac involvement is a recognized, though not fully characterized, complication in pediatric HIV infection.
Purpose:
- To investigate the prevalence and natural history of cardiac abnormalities in children perinatally exposed to HIV-1.
- To correlate cardiac findings with clinical and immunological status in HIV-exposed children.
Summary:
- Eighty-four children exposed to HIV-1 underwent serial clinical, electrocardiographic (ECG), and echocardiographic (ECHO) evaluations.
- HIV-infected children (48.8%) showed a 51.2% frequency of cardiac abnormalities, with higher prevalence in those with advanced clinical and immunological disease.
- Common findings included congestive heart failure (CHF) clinically, ventricular repolarization changes on ECG, and dilated cardiomyopathy on ECHO; ECG abnormalities were most frequent.
Impact:
- Cardiac involvement is a significant characteristic of pediatric HIV infection, especially in advanced stages.
- Understanding these cardiac manifestations aids in comprehensive patient management and monitoring.
- Electrocardiogram monitoring may be particularly valuable for detecting cardiac involvement in this population.
Objective:
To determine the frequency of cardiac abnormalities and its natural history in children perinatally exposed to HIV-1.
Methods:
Eighty-four children exposed to HIV-1 were evaluated by serial clinical, electrocardiographic (ECG), and Doppler-echocardiographic (ECHO) examinations.
Results:
Group I--(seroreversion)--43 children (51.2%). Absence of clinical abnormalities. ECG: incomplete right bundle branch block (RBBB) 5 cases. ECHO: atrial septal defect (ASD) and ventricular septal defect (VSD)--1 case each. Group II--41 HIV-infected children (48.8%), of whom 51.2% were found to have cardiac abnormalities. Asymptomatic or mildly symptomatic children without immunosuppression: no clinical and echocardiographic abnormalities; ECG: incomplete right bundle branch block (RBBB)--(2 cases). Children with moderate and severe symptoms and immunological impairment: the following abnormalities were found: 1) clinical (31.7%)-isolated tachycardia (1 case), congestive heart failure (12 cases). 2) electrocardiographic (43.9%)- sinus tachycardia associated with other abnormalities (10 cases), incomplete right bundle branch block (5 cases), left anterior hemiblock (1 case), right anterior hemiblock (1 case), changes in ventricular repolarization (11 cases), right ventricular overload (2 cases), left ventricular overload (1 case), right QRS axis deviation (1 case), and arrhythmias (3 cases). 3) echocardiographic (26.8%)- dilated cardiomyopathy (5 cases), pericardial effusion with tamponade (2 cases), pulmonary hypertension (2 cases), and mitral valve prolapse (1 case).
Conclusion:
Cardiac involvement was a characteristic of the HIV-infected group. Higher prevalence of abnormalities was found among children belonging to the most advanced clinical and immunological category. The most commonly observed clinical, electrocardiographic and echocardiographic findings were congestive heart failure (CHF), changes in ventricular repolarization, and dilated cardiomyopathy, respectively. The latter was reversible in one case. Electrocardiogram changes were significantly more frequent than clinical and echocardiographic changes.
