Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2002 Aug 3;360(9330):368-73.
doi: 10.1016/S0140-6736(02)09607-1.

Cardiovascular status of infants and children of women infected with HIV-1 (P(2)C(2) HIV): a cohort study

Steven E Lipshultz  1 , Kirk A Easley, E John Orav, Samuel Kaplan, Thomas J Starc, J Timothy Bricker, Wyman W Lai, Douglas S Moodie, George Sopko, Mark D Schluchter, Steven D Colan; Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection (P(2)C(2) HIV) Study Group
Affiliations
Multicenter Study

Cardiovascular status of infants and children of women infected with HIV-1 (P(2)C(2) HIV): a cohort study

Steven E Lipshultz et al. Lancet. .

Abstract

Background: Data from cross-sectional and short-term longitudinal studies have suggested that children infected with HIV-1 might have cardiovascular abnormalities. We aimed to investigate this hypothesis in a long-term cohort study.

Methods: We measured cardiovascular function every 4-6 months for up to 5 years in a birth cohort of 600 infants born to women infected with HIV-1. We included 93 infants infected with HIV-1 and 463 uninfected infants (internal controls) from the same cohort. We also included a cross-sectionally measured comparison group of 195 healthy children born to mothers who were not infected with HIV-1 (external controls).

Findings: Children infected with HIV-1 had a significantly higher heart rate at all ages (mean difference 10 bpm, 95% CI 8-13) than internal controls. At birth, both cohort groups of children had similar low left ventricular (LV) fractional shortening. At 8 months, fractional shortening was similar in internal and external controls, whereas in children infected with HIV-1, fractional shortening remained significantly lower than in controls for the first 20 months of life (mean difference from internal controls at 8 months 3.7%, 2.3-5.1). LV mass was similar at birth in both cohort groups, but became significantly higher in children with HIV-1 from 4-30 months (mean difference 2.4 g at 8 months, 0.9-3.9).

Conclusions: Vertically-transmitted HIV-1 infection is associated with persistent cardiovascular abnormalities identifiable shortly after birth. Irrespective of their HIV-1 status, infants born to women infected with HIV-1 have significantly worse cardiac function than other infants, suggesting that the uterine environment has an important role in postnatal cardiovascular abnormalities.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Longitudinal change in mean left ventricular fractional shortening in children born to women infected with HIV-1
*n=428 internal controls. †n=86 children with HIV-1 infection. Vertical bars=95% CIs.
Figure 2
Figure 2. Longitudinal change in echocardiographic measurements in children born to women infected with HIV-1
Contractility was measured by the stress-velocity index. Left ventricular mass and end-diastolic dimension were adjusted for body surface area.
See this image and copyright information in PMC

Comment in

References

    1. NAIDS Joint United Nations Programme on HIV/AIDS. [accessed April 23, 2001];AIDS epidemic update. 2000 Dec; http://www.unaids.org/epidemic_update/report_dec00/index_dec.html#full.
    1. UNAIDS Joint United Nations Programme on HIV/AIDS. [accessed March 25, 2001];Report on the global HIV/AIDS epidemic. 2000 Jun; http://www.unaids.org/epidemic_update/report/index.html.
    1. US Centers for Disease Control and Prevention. [accessed March 25, 2002];HIV/AIDS surveillance report. 2000 7:1–43. http://www.cdcgov/hiv/stats/hasrsupp71.htm.
    1. Lipshultz SE, Easley KA, Orav EJ, et al. Left ventricular structure and function in children infected with human immunodeficiency virus: the prospective P2C2 HIV multicenter study. Circulation. 1998;97:1246–56. - PMC - PubMed
    1. Starc TJ, Lipshultz SE, Kaplan S, et al. Cardiac complications in children with human immunodeficiency virus infection. [accessed April 23, 2001];Pediatrics. 1999 104 (online):e14. http://www.pediatrics.org/cgi/content/full/104/2/e14. - PMC - PubMed

Publication types