Congenital Cardiovascular Malformations in HIV-Infected Children

Most pediatric patients with HIV are infected in the perinatal period [22]. In a prospective longitudinal multicenter study, diagnostic echocardiograms were performed at 4- to 6-month intervals on two cohorts of children exposed to maternal HIV-1 infection: (1) a neonatal cohort of 90 HIV-infected, 449 HIV-uninfected, and 19 HIV-indeterminate children; and (2) an older HIV-infected cohort of 201 children with vertically transmitted HIV-1 infection recruited after 28 days of age [22].

In the neonatal cohort, 36 lesions were seen in 36 patients, yielding an overall congenital cardiovascular malformation prevalence of 6.5% (36/558), with 8.9% (8/90) prevalence in HIV-infected children and 5.6% (25/449) prevalence in HIV-uninfected children [22]. Two children (2/558, 0.4%) had cyanotic lesions. In the older HIV-infected cohort, there was a congenital cardiovascular malformation prevalence of 7.5% (15/201). The distribution of lesions did not differ significantly between the groups. There was no statistically significant difference in congenital cardiovascular malformation prevalence in the HIV-infected compared to the HIV-uninfected children born to HIV-infected women. With the use of early screening echocardiography, rates of congenital cardiovascular malformations in both the HIV-infected and HIV-uninfected children were five- to tenfold higher than rates reported in population-based epidemiologic

Table 1 Principal HIV-associated cardiovascular abnormalities. (From [3], with permission)

Table 1 cont.

Type	Possible etiologies and associations	Incidence
HIV-associated pulmonary hypertension	Recurrent bronchopulmonary infections, pulmonary arteritis, microvascular pulmonary emboli due to thrombus or drug injection. Plexogenic pulmonary arteriopathy. Mediator release from endothelium	1/200 of HIV-infected persons before the introduction of HAART [20]
AIDS-related tumors	Kaposi’s sarcoma	12%-28% of AIDS patients before the introduction of HAART [20,21]
	Non-Hodgkin’s lymphomas	Mostly limited to case reports before the introduction of HAART

studies, but not higher than in normal populations similarly screened [22].

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Source: Barbaro Giuseppe, Boccara Franc (eds.). Cardiovascular Disease in AIDS. 2nd edition. — Springer,2009. — 169 p.. 2009

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