Cardiovascular manifestations of HIV infection in children

Idris, Nikmah Salamia; Grobbee, Diederick E.; Burgner, David; Cheung, Micheal M H; Kurniati, Nia; Sastroasmoro, Sudigdo; Uiterwaal, Cuno S.P.M.

doi:10.1177/2047487314560086

Cited by 18 publications

(14 citation statements)

References 71 publications

(93 reference statements)

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“…cardiomyopathy) decreased significantly. However, asymptomatic structural abnormalities in HIV-infected children persist during ART and they may be related to subsequent clinically evident diseases in adult life [46]. In HIV-infected adults, many factors may contribute to vascular diseases, including classical risk factors (i.e., obesity, diabetes, hypertension, sedentary life, smoke), the side effects of long-term ART, and HIV-related inflammation and immune activation on heart and vessels [47–49].…”

Section: Resultsmentioning

confidence: 99%

Accelerated aging in perinatally HIV-infected children: clinical manifestations and pathogenetic mechanisms

Chiappini

Bianconi

Dalzini

et al. 2018

Aging

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Background: Premature aging and related diseases have been documented in HIV-infected adults. Data are now emerging also regarding accelerated aging process in HIV-infected children.Methods: A narrative review was performed searching studies on PubMed published in English language in 2004-2017, using appropriate key words, including “aging”, “children”, “HIV”, “AIDS”, “immunosenescence”, “pathogenesis”, “clinical conditions”.Results: Premature immunosenescence phenotype of B and T cells in HIV-infected children is mediated through immune system activation and chronic inflammation. Ongoing inflammation processes have been documented by increased levels of pathogen-associated molecular patterns (PAMPS), increased mitochondrial damage, higher levels of pro-inflammatory cytokines, and a positive correlation between sCD14 levels and percentages of activated CD8+ cells. Other reported features of premature aging include cellular replicative senescence, linked to an accelerated telomeres shortening. Finally, acceleration of age-associated methylation pattern and other epigenetic modifications have been described in HIV-infected children. All these features may favor the clinical manifestations related to premature aging. Lipid and bone metabolism, cancers, cardiovascular, renal, and neurological systems should be carefully monitored, particularly in children with detectable viremia and/or with CD4/CD8 ratio inversion.Conclusion: Aging processes in children with HIV infection impact their quality and length of life. Further studies regarding the mechanisms involved in premature aging are needed to search for potential targets of treatment.

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Section: Resultsmentioning

confidence: 99%

Accelerated aging in perinatally HIV-infected children: clinical manifestations and pathogenetic mechanisms

Chiappini

Bianconi

Dalzini

et al. 2018

Aging

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“…1-3 Persons living with HIV are at elevated risk of various manifestations of CVD, including myocardial infarction, pulmonary hypertension, congestive heart failure, and atrial arrhythmias. 2,4-10 Furthermore, HIV+ persons appear to have a several-fold greater risk of sudden cardiac death (SCD) than uninfected persons. 7 Ventricular arrhythmia is the most common cause of SCD in adults, but little is known about the prevalence and origin of ventricular ectopy and ventricular tachycardia (VE/VT) in HIV+ persons.…”

Section: Introductionmentioning

confidence: 99%

Ventricular Ectopy and Arrhythmia Characteristics for Persons Living with HIV and Uninfected Controls

Meyer

Dandamudi

Achenbach

et al. 2019

J Int Assoc Provid AIDS Care

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Background:Persons with HIV have elevated risk for cardiovascular disease, but little is known about the risk of ventricular ectopy and ventricular tachycardia (VE/VT) for HIV-infected (HIV+) persons.Methods:We evaluated the presence and anatomic origin of VE/VT for HIV+ persons and controls by screening a cohort using International Classification of Diseases codes and adjudicating positive screens by chart review. We sought to evaluate (1) presence of VE/VT and (2) likely anatomic origin of the VE/VT based on electrocardiogram.Results:There was no significant difference in the prevalence of VE/VT for HIV+ or uninfected persons. Among HIV+ persons, worse HIV control was associated with significantly greater odds of VE/VT. Exploratory analyses suggested that HIV+ persons may have a greater likelihood of VE/VT originating from the left ventricle.Conclusion:Although worse HIV control was associated with higher odds of VE/VT among persons with HIV, odds of VE/VT were not higher for persons with HIV than uninfected persons.

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“… 1 Cardiac involvement may have diverse manifestations from initial asymptomatic presentation to overt heart failure to sudden death. 2 With increased longevity of HIV-infected children, this chronic non-infectious complication becomes a confronting clinical challenge. 3 There is an urgent need to better understand the impact of HIV infection on the developing cardiovascular system, including its underlying mechanisms, which most likely represent a complex interplay between HIV, antiretroviral therapy (ART), inflammation and co-infections.…”

Section: Introductionmentioning

confidence: 99%

Effects of paediatric HIV infection on electrical conduction of the heart

et al. 2016

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ObjectiveTo investigate the effects of HIV infection in children on heart electrical conduction, particularly to delineate the effects of HIV infection from treatment.MethodsOn a 12-lead ECG, available for 37 antiretroviral therapy (ART) naïve, 42 ART-exposed vertically-acquired HIV-infected and 50 healthy children in Jakarta, Indonesia, we measured cardiac conduction parameters: PR, QRS, and QTc (corrected using Bazett's formula) intervals. The associations between HIV infection/treatment status and ECG intervals were evaluated using general linear modelling with further adjustment for potential confounders or intermediary variables. Findings are presented as (adjusted) mean differences between each of the two HIV groups and healthy children.ResultsAlthough not exceeding the clinical threshold for long QT (QTc >460 ms for girls and >440 ms for boys) compared to healthy children, mean QTc intervals were longer in ART-naïve (difference 18.2 ms, 95% CI 7.0 to 29.3) and, to greater extent, in ART-exposed HIV-infected children (difference 28.9 ms, 19.3 to 38.5). Following adjustment for RR interval, age and height, prolongation of PR interval was seen only in ART-naïve HIV-infected children (difference 12.9 ms, 2.4 to 23.3). Cardiac mass/function, high-sensitive C reactive protein, cholesterol and glycated haemoglobin levels, systolic and diastolic blood pressures, or postnatal parental smoking exposure did not affect these associations. No difference in the QRS interval was observed between groups.ConclusionsProlongation of the QTc interval occurs in ART-naïve HIV-infected children and, to a greater extent, in the ART-exposed children, whereas a longer PR interval appears to be seen only among ART-naïve HIV-infected children.

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Cardiovascular manifestations of HIV infection in children

Cited by 18 publications

References 71 publications

Accelerated aging in perinatally HIV-infected children: clinical manifestations and pathogenetic mechanisms

Accelerated aging in perinatally HIV-infected children: clinical manifestations and pathogenetic mechanisms

Ventricular Ectopy and Arrhythmia Characteristics for Persons Living with HIV and Uninfected Controls

Effects of paediatric HIV infection on electrical conduction of the heart

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