Study of the cardiac alterations in HIV-infected children consequent to the antiretroviral therapy: prospective study of 47 cases

Herdy, Gesmar Volga Haddad; Pinto, Carlos Alberto; Lopes, Vânia Glória Silami; Ribeiro, Raquel; Gomes, Ivete Martins; Tchou, Hsu Y.; Melo, Renata Amanajás de; Kurdian, Bedros; Tavares, Plínio de Assis

doi:10.1590/s0066-782x2003000300007

Cited by 10 publications

(13 citation statements)

References 21 publications

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“…The functional consequences of azidothymidine treatment have been found as dilated and hypertrophic cardiomyopathy, cardiac conduction defects, myocarditis, and even sudden death (Domanski et al . 1995; Herdy et al . 2003).…”

Section: Discussionmentioning

confidence: 99%

Protection of Azidothymidine‐Induced Cardiopathology in Mice by Mildronate, a Mitochondria‐Targeted Drug

Kluša¹,

Pupure²,

Isajevs

et al. 2006

Basic Clin Pharma Tox

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Azidothymidine, a nucleoside-analogue reverse transcriptase inhibitor (NRTI), is a commonly used antiretroviral drug in AIDS treatment, however its use is limited by severe toxic side effects due to its influence on mitochondria that result in myopathy, particularly affecting the cardiac muscle. We suggest that effective protection of azidothymidineinduced cardiopathology can be expected from drugs that are capable of targeting mitochondria. Therefore the present study in mice was carried out with mildronate, a cardioprotective drug of the aza-butyrobetaine class, which previously has been shown to act as a highly potent protector of mitochondrial processes. In our study, saline (control), azidothymidine (50 mg/kg), mildronate (50, 100 and 200 mg/kg), and azidothymidine π mildronate (at the doses mentioned) were injected intraperitoneally daily in separate groups of mice for two weeks. At the termination of the experiment, mice were sacrificed, the hearts were removed and cardiac tissue was examined morphologically and immunohistochemically. It was found that azidothymidine, compared to control and mildronate groups, induced major morphologic changes in cardiac tissue, which were manifestated as degeneration and inflammation. These changes were prevented when mildronate was co-administered with azidothymidine. Mildronate also reduced the azidothymidine-induced expression of nuclear factor kBp65 (NF-kBp65). The obtained data demonstrate a high ability of mildronate of preventing azidothymidine-induced cardiopathologic changes, and suggest mildronate's indirect action on azidothymidine-caused oxidative stress reactions leading to mitochondrial dysfunction. This offers a rational combination of mildronate with azidothymidine or other anti-HIV drugs for beneficial application in AIDS therapy.

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Section: Discussionmentioning

confidence: 99%

Protection of Azidothymidine‐Induced Cardiopathology in Mice by Mildronate, a Mitochondria‐Targeted Drug

Kluša¹,

Pupure²,

Isajevs

et al. 2006

Basic Clin Pharma Tox

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“…In Brazil, HIV-infected children treated with AZT were more likely to develop HF than children treated with combination ART (78). Conversely, combination ART, but not AZT monotherapy, improves LV function in children with HIV-associated HF (70).…”

Section: Epidemiology Of Hiv-associated Hf In Lmics In the Art Eramentioning

confidence: 99%

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

Bloomfield

Alenezi

Barasa

et al. 2015

JACC: Heart Failure

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Successful combination therapy for human immunodeficiency virus (HIV) has transformed this disease from a short-lived infection with high mortality to a chronic disease associated with increasing life expectancy. This is true for high- as well as low- and middle-income countries. As a result of this increased life expectancy, people living with HIV are now at risk of developing other chronic diseases associated with aging. Heart failure has been common among people living with HIV in the eras of pre- and post- availability of antiretroviral therapy; however, our current understanding of the pathogenesis and approaches to management have not been systematically addressed. HIV may cause heart failure through direct (e.g., viral replication, mitochondrial dysfunction, cardiac autoimmunity, autonomic dysfunction) and indirect (e.g., opportunistic infections, antiretroviral therapy, alcohol abuse, micronutrient deficiency, tobacco use) pathways. In low- and middle-income countries, 2 large observational studies have recently reported clinical characteristics and outcomes in these patients. HIV-associated heart failure remains a common cardiac diagnosis in people living with heart failure, yet a unifying set of diagnostic criteria is lacking. Treatment patterns for heart failure fall short of society guidelines. Although there may be promise in cardiac glycosides for treating heart failure in people living with HIV, clinical studies are needed to validate in vitro findings. Owing to the burden of HIV in low- and middle-income countries and the concurrent rise of traditional cardiovascular risk factors, strategic and concerted efforts in this area are likely to impact the care of people living with HIV around the globe.

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“…Alves, Kovács, Stall and Paiva (2001) interviewed 26 infected women and 14 had the diagnostic test after their partner or child became ill. Vermelho, Barbosa and Nogueira (1999) reported that several women "received their diagnosis and initial medical care only after their partners' and/or children's illness or death." Herdy et al (2003) presented a high percentage of the children who were index cases. Twenty-six patients (57.0%) out of 45 were index cases.…”

Section: Discussionmentioning

confidence: 96%

“…Starting from the late 1980s, an increase in publications on the issue by Sherlock (1988), Chiattone, (1984, Duarte, Meirelles, Bruno and Duarte (1987), Guimarães (1988) has been reported. Further, Lindquist (1996), Pinheiro andLopes (1993), Junqueira, (1999), Melo e Valle (2003), Herdy et al (2003), Motta and Enumo (2004); Mitre and Gomes (2004) ;Pedrosa, Monteiro, Lins, Pedrosa, and Melo (2007) have been recently added.…”

mentioning

confidence: 99%

The knowledge and perceptions of HIV positive children and their parents or responsibles about AIDS

Drummond¹,

Pinto²,

Mesquita³

et al. 2008

Psicol. estud.

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ABSTRACT. In this study knowledge and perceptions of parents and/or responsibles and of their HIV infected children and adolescents in a national health clinic of pediatric Aids were investigated. Observation techniques and semi-structured interviews were used before the installation of a playroom to investigate: the discovery of the HIV infection by the family, their social conditions, access to prevention and treatment and their perception of the disease. Results show that a significant number of relatives interviewed (n=28) realized that they were also HIV-carriers when their children's health deteriorated (14 or 50.0 %); the death of the spouse occurred (6 or 21.4%) and by the symptoms of the disease in themselves (8 or 28.6%). Among the 32 children interviewed, 28 (87.5%) were not aware of their diagnosis and 18 (56.3%) were not enroled into school. Out of the 14 different schools frequented by 14 (43.8%) children, only 7 (50%) of these institutions knew about the children's diagnosis. Analysis of drawings and general playroom activities indicate that the playroom is a promising environment for the promotion of health information and continued dialog, stimulating adhesion to treatmet.Key words: Pediatric AIDS, playroom, health education. OS CONHECIMENTOS E PERCEPÇÕES DE CRIANÇAS HIV POSITIVAS E DE SEUS PAIS OU RESPONSÁVEIS SOBRE AIDSRESUMO. Este trabalho objetivou estudar os conhecimentos e percepções de pais/responsáveis e de suas crianças e adolescentes de um ambulatório de Aids pediátrica. Foi investigado: A descoberta do vírus pela família; as condições sociais, o acesso à prevenção e tratamento e a percepção da doença. Foram realizadas observações participantes e entrevistas semi-estruturadas, previamente à implantação de uma brinquedoteca. Os resultados revelam que 14 (50%) dos familiares entrevistados (n=28) toma consciência de que são portadores do HIV através do adoecimento das crianças, 6 (21,4%) pela morte de um dos cônjuges e 8 (28,6%) pelos sintomas da doença deles próprios. Das crianças entrevistadas (n=32), 28 (87,5%) não tinham conhecimento do diagnóstico, 18 (56,3%) não freqüentavam escola. Das 14 (43,8%), crianças escolarizadas em 14 diferentes instituições, 7 das escolhas (50%) não tinham conhecimento do diagnóstico da criança. A análise das representações gráficas e atividades gerais na brinquetodeca indicam o seu potencial enquanto ambiente promissor para intervenção terapêutica, promoção do diálogo, podendo tornar-se estímulo à adesão ao tratamento.Palavras-chave: Aids pediátrica, brinquedoteca, educação em saúde. LOS CONOCIMIENTOS Y PERCEPCIONES DE LOS NIÑOS Y DE SUS PADRES/CUIDADORES ACERCA DE SIDARESUMEN. Este trabajo apuntó a estudiar los conocimientos y percepciones de los padres/cuidadores y de sus niños y adolescentes en un dispensario de sida pediátrico. Se investigaron: la descubierta del virus por la familia; las condiciones sociales; el acceso a la prevención, tratamiento y la percepción de la enfermedad. Los resultados muestran que el 14-50% de los familiares (n=28) descubr...

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Study of the cardiac alterations in HIV-infected children consequent to the antiretroviral therapy: prospective study of 47 cases

Cited by 10 publications

References 21 publications

Protection of Azidothymidine‐Induced Cardiopathology in Mice by Mildronate, a Mitochondria‐Targeted Drug

Protection of Azidothymidine‐Induced Cardiopathology in Mice by Mildronate, a Mitochondria‐Targeted Drug

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

The knowledge and perceptions of HIV positive children and their parents or responsibles about AIDS

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