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
. 2013 Apr 24;27(7):1099-108.
doi: 10.1097/QAD.0b013e32835cf21c.

Cardiac biomarkers in HIV-exposed uninfected children

James D Wilkinson  1 , Paige L Williams, Erin Leister, Bret Zeldow, William T Shearer, Steven D Colan, George K Siberry, Laurie B Dooley, Gwendolyn B Scott, Kenneth C Rich, Steven E Lipshultz; Pediatric HIVAIDS Cohort Study (PHACS)
Collaborators, Affiliations

Cardiac biomarkers in HIV-exposed uninfected children

James D Wilkinson et al. AIDS. .

Abstract

Objectives: To evaluate associations of cardiac biomarkers with in-utero antiretroviral drug exposures and cardiac function/structure measured by echocardiograms in HIV-exposed but uninfected (HEU) children.

Design and methods: We analyzed the association of three cardiac biomarkers (cardiac troponin T, cTnT; high sensitivity C-reactive protein, hsCRP; and N-terminal pro-brain natriuretic peptide, NT-proBNP) with prenatal antiretroviral drug exposures, maternal-child characteristics, and echocardiographic parameters.

Results: Among 338 HEU children (mean age 4.3 years), 51% had at least one elevated cardiac biomarker. Maternal tobacco use was associated with elevated NT-proBNP [adjusted odds ratio (aOR) 2.28, P=0.02]. Maternal alcohol and abacavir use were associated with elevated cTnT levels (aOR 3.56, P=0.01 and aOR 2.33, P=0.04, respectively). Among 94 children with paired echocardiogram-biomarker measurements, cTnT measurements were correlated with increased left-ventricular thickness-to-dimension ratio (r=0.21, P=0.04); and elevated cTnT was associated with higher mean left-ventricular end-diastolic (LVED) posterior wall thickness (P=0.04). hsCRP measurements were negatively correlated with septal thickness (r=-0.22, P=0.03) and elevated hsCRP was associated with lower mean left-ventricular contractility Z-scores (P=0.04). NT-proBNP measurements were correlated with increased LVED dimension (r=0.20, P=0.05) and elevated NT-proBNP was associated with lower mean end-systolic septal thickness (P=0.03).

Conclusion: Our findings suggest that cardiac biomarkers may help identify HEU children who require further cardiac evaluation including echocardiography. Potential cardiac effects of prenatal abacavir exposure in this population need further investigation.

PubMed Disclaimer

Figures

Figure 1
Figure 1. A comparison of all SMARTT children with elevated biomarkers compared to those with an echocardiogram within 3 months of the biomarker assays
The percent (%) of study children with elevated cardiac biomarker levels, for those with an accompanying echocardiogram within 3 months of a biomarker assay (n=94) versus the entire study cohort (n=338). cTnT=cardiac troponin T; hsCRP=high-sensitivity C-reactive protein; NT-proBNP=N-terminal pro-brain natriuretic peptide.
See this image and copyright information in PMC

References

    1. Whitmore SK, Zhang X, Taylor AW, Blair JM. Estimated number of infants born to HIV-infected women in the United States and five dependent areas. J Acquir Immune Defic Syndr. 2011;57:218–222. - PubMed
    1. Department of Health and Human Services Centers for Disease Control and Disease Prevention HIV Surveillance Supplemental Report: Table 4[serial online] Available at. 2011 http://www.cdc.gov/hiv/surveillance/resources/reports/2010supp_vol16no2/... February 17, 2012.
    1. Lipshultz SE, Shearer WT, Thompson B, Rich KC, Cheng I, Orav EJ, et al. Cardiac effects of antiretroviral therapy in HIV-negative infants born to HIV-positive mothers: NHLBI CHAART-1 (National Heart, Lung, and Blood Institute Cardiovascular Status of HAART Therapy in HIV-Exposed Infants and Children cohort study). J Am Coll Cardiol. 2011;57:76–85. - PMC - PubMed
    1. Hazra R, Siberry GK, Mofenson LM. Growing up with HIV: children, adolescents, and young adults with perinatally acquired HIV infection. Annu Rev Med. 2010;61:169–185. - PubMed
    1. Lipshultz SE, Fisher SD, Lai WW, Miller TL. Cardiovascular risk factors, monitoring, and therapy for HIV-infected patients. AIDS. 2003;17(Suppl 1):S96–S122. - PubMed

Publication types

MeSH terms