Left Ventricular Changes and Inflammatory Biomarkers in HIV-Exposed Uninfected Infants in Jos, Northcentral Nigeria

Cardiac remodeling has been reported in HIV-exposed but uninfected (HEU) infants. Inflammatory biomarkers have also been observed to be associated with cardiac remodeling in older HEU children but have not been widely studied in infants. We identified left ventricular (LV) cardiac changes in HEU infants exposed to current ARV therapy in utero and determined their association with the inflammatory biomarkers, C-reactive protein (CRP), and cardiac troponin. This comparative cross-sectional study included 196 HEU infants and 198 matched HIV-unexposed controls. We evaluated LV structure and function using echocardiography and tested blood samples using highly sensitive CRP (hsCRP) and cardiac troponin I (cTnI-plus) measurements. Data were analyzed using the R statistical software package; p values of < 0.05 were considered statistically significant. The HEU infants had thicker LV posterior walls and interventricular septa in diastole (median difference 0.55 and 0.30, 95% CI 0.22-0.89 and 0.13-0.54, respectively, p < 0.001), higher left ventricular mass index (median difference 3.8, 95% CI 1.2-6.9, p < 0.001), and left ventricular wall thickness-to-diameter ratio (median difference 0.02, 95% CI 0.01-0.03, p < 0.001) compared with controls. The interventricular septa Z score was significantly thicker in HEU infants with elevated hsCRP levels (AOR 2.3, 95% CI 1.22-3.36, p = 0.006). Cardiac remodeling is present in HEU infants exposed to current ARV regimens in utero. Longitudinal studies are required to identify infants who may require cardiac evaluation and further explore biomarkers associated with cardiac remodeling in HEU infants.