UM Pediatrics Chairman Publishes Findings on HIV and Heart Disease

Children infected with HIV by their mothers are providing important answers about the progression of heart disease. In a study just published in the American Heart Journal researchers followed close to 200 children at five clinical centers across the United States. All of the children suffered a deterioration in the structure and function of their heart from the time of their birth, which progressed during the first three years of life, then leveled out to mild and persistent over the ensuing years of the follow-up.
“This patient population offered an opportunity to follow children over time to see what impact mild dilated cardiomyopathy and increased left ventricular mass had on overall mortality,” said Steven E. Lipshultz, M.D., professor and chairman of the Department of Pediatrics at the University of Miami Leonard M. Miller School of Medicine and a principal investigator of the study. “In other patient populations, we already know that moderate or severe cardiac dysfunction has an impact on cardiac mortality, but mild abnormalities have not been assessed.”
During the course of the study, the children underwent echocardiograms to assess their cardiac health at regular intervals. The researchers observed that mild but persistent cardiac dysfunction in HIV-infected children was linked to an increased rate of clinical congestive heart failure and death. Mild abnormalities of cardiac function or mass at these levels were not previously thought to be significant, but the study finds they were actually strongly related to subsequent mortality.
Before the use of highly active antiretroviral therapy, the mean life expectancy for an HIV-infected child was nine years, but longevity is increasing with new therapies. “It’s important for us to better understand the cardiovascular abnormalities that develop in these children to better develop therapeutic and preventive strategies,” said Dr. Lipshultz.
The study, funded by the National Heart, Lung, and Blood Institute, suggests that more research is needed to determine if earlier therapy for these heart problems can prompt improved outcomes.