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Cardiac Effects of Highly Active Antiretroviral Therapy in Perinatally HIV-Infected Children: The CHAART-2 Study

Steven E Lipshultz1, James D Wilkinson2, Bruce Thompson3

  • 1Wayne State University School of Medicine, Detroit, Michigan; Children's Hospital of Michigan, Detroit, Michigan.

Journal of the American College of Cardiology
|October 28, 2017
PubMed

Insights

Highly active antiretroviral therapy (HAART) improved cardiac structure and function in HIV-infected children compared to the pre-HAART era. However, long-term cardiovascular health requires ongoing monitoring and evidence-based strategies.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • HIV/AIDS Research

Background:

  • Cardiac complications were prevalent in HIV-infected children before highly active antiretroviral therapy (HAART).
  • Understanding the long-term cardiovascular impact of HAART is crucial for managing HIV-infected children.

Purpose of the Study:

  • To investigate the long-term cardiovascular effects of HAART in children with HIV.
  • To compare cardiac structure and function in HAART-exposed versus HAART-unexposed HIV-infected children.

Main Methods:

  • Prospective comparison of echocardiograms from HAART-exposed and HAART-unexposed HIV-infected children.
  • Utilized centralized echocardiographic interpretation and z-scores referenced to healthy controls.
  • Generalized estimating equations were used to evaluate associations between HAART exposure and echocardiographic measures.

Main Results:

  • HAART exposure was associated with increased left ventricular (LV) fractional shortening and LV contractility.
  • Longer HAART duration correlated with improved LV fractional shortening and heart rate.
  • HAART exposure was linked to reduced LV mass and septal thickness, but these measures declined over time.

Conclusions:

  • Cardiac structure and function were generally better in HAART-exposed HIV-infected children compared to the pre-HAART era.
  • A decline in cardiac structure and function was observed over time in HAART-exposed children.
  • Evidence-based cardiovascular monitoring strategies are essential for optimizing long-term health outcomes in this population.
Abstract

Keywords:
HIVantiretroviral therapycardiomyopathypediatric

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