Objective: To describe the five-year cumulative incidence of cardiac dysfunction in human immunodeficiency virus (HIV)-infected children.

Study Design: We used a prospective cohort design, enrolling children at 10 hospitals. Group I included 205 vertically HIV-infected children enrolled at a median age of 1.9 years. Group II consisted of 600 HIV-exposed children enrolled prenatally or as neonates, of whom 93 were ultimately HIV-infected. The main outcome measures were echocardiographic indexes of left ventricular dysfunction.

Results: In Group I, the five-year cumulative incidence of left ventricular fractional shortening <25 percent was 28 percent. The five-year incidence of left ventricular end-diastolic dilatation was 21.7 percent, and heart failure and/or the use of cardiac medications 28.8 percent. The mortality rate one year after the diagnosis of heart failure was 52.5 percent [95 percent CI, 30.5-74.5]. Within Group II, the five-year cumulative incidence of decreased fractional shortening was 10.7 percent in the HIV-infected compared with 3.1 percent in the HIV-uninfected children (p= .01). Left ventricular dilation, heart failure, and/or the use of cardiac medications were more common in infected compared with uninfected children.

Conclusions: During five years of follow-up, cardiac dysfunction occurred in 18 percent to 39 percent of HIV-infected children and was associated with an increased risk of death. [T.J. Starc et al.; J Pediatr; 2002 Sep;141(3):327-34.]

Back to the October 2002 issue of IAPAC Monthly.