Cardiovascular Complications in Children with HIV Infection

Abstract

Before effective antiretroviral treatment was introduced in children with HIV, cardiovascular complications were a major cause of morbidity and mortality. Now that antiretroviral treatment is the standard of care in this population, there has been a shift from fulminant cardiovascular complications to recognition of cardiovascular issues related to HIV as a chronic disease state and its treatment. This review explores the recent advances in understanding the roles of atherosclerosis, inflammation, biomarkers, and metabolic abnormalities in cardiac function and cardiovascular disease risk in children with HIV. The true risk and prevalence of cardiovascular outcomes in HIV-infected children and adolescents has yet to be realized. Recently, however, investigators are exploring new cardiovascular health challenges that face children living with HIV, and developing strategies to lower the cardiovascular disease risk for these children.

Evaluation of right ventricular function by Doppler tissue imaging of the tricuspid annulus in patients with acquired immune deficiency syndrome

“…Recently, the improved control of opportunistic infection has resulted in a greater awareness of cardiovascular complications in individuals who are HIV positive or have AIDS (7–9). Generally, cardiac complications are asymptomatic and may be masked by symptoms of other complications, which leads to negative results for X-ray and ECG examinations (10,11).…”

HIV-infected Children in Malawi Have Decreased Performance on the 6-minute Walk Test With Preserved Cardiac Mechanics Regardless of Antiretroviral Treatment Status

“…Before the availability of antiretroviral therapy (ART), children with HIV often suffered from severe cardiac sequelae, including pericarditis, myocarditis, cardiomyopathy, pulmonary arterial hypertension, valvular disease, aortic dilation, and arrhythmias(1–4). In children, one third of HIV-related deaths in the pre-ART era could be attributed to cardiac causes (2, 3).…”

“…In children, one third of HIV-related deaths in the pre-ART era could be attributed to cardiac causes (2, 3). Even as ART has decreased the burden of cardiac disease in children infected with HIV in both resource rich and limited settings(1), concern has shifted to cardiac complications that present later in life(5). HIV-infected children are often exposed to ART while the cardiovascular system is still developing and sub-clinical cardiac dysfunction detected in childhood could develop into symptomatic cardiomyopathy in adulthood (6).…”

Effects of paediatric HIV infection on electrical conduction of the heart

“…Vertically acquired HIV infection is a devastating disease in childhood which may affect any organs, including the cardiovascular system. 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.…”