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Long-term cardiac follow-up of children with perinatally acquired human immunodeficiency virus-type 1 infection

Published online by Cambridge University Press:  19 August 2008

Luciano De Simone ,
Maurizio de Martino ,
Luisa Galli ,
Adriano Manetti ,
Silvia Favilli ,
Iva Pollini ,
Giuseppe Calabri ,
Francesco Mannelli  and
Alberto Vierucci
Luciano De Simone*
Affiliation:
From the Cardiology Unit, University of Florence, Florence
Maurizio de Martino
Affiliation:
Anna Meyer Children's Hospital and the Department of Pediatrics, Florence
Luisa Galli
Affiliation:
Anna Meyer Children's Hospital and the Department of Pediatrics, Florence
Adriano Manetti
Affiliation:
From the Cardiology Unit, University of Florence, Florence
Silvia Favilli
Affiliation:
From the Cardiology Unit, University of Florence, Florence
Iva Pollini
Affiliation:
From the Cardiology Unit, University of Florence, Florence
Giuseppe Calabri
Affiliation:
Anna Meyer Children's Hospital and the Department of Pediatrics, Florence
Francesco Mannelli
Affiliation:
Anna Meyer Children's Hospital and the Department of Pediatrics, Florence
Alberto Vierucci
Affiliation:
Anna Meyer Children's Hospital and the Department of Pediatrics, Florence
*
Dr. Luciano De Simone Via Luca Giordano 13, Cardiology Unit, Anna Meyer Children's Hospital, Florence, Italy. Tel. 055-5662498; Fax. 055-570380.
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Abstract

Since 1985 a physical and instrumental cardiac study was carried out in 41 children with perinatal HIV-1 infection in order to assess the prevalence and natural history of cardiac involvement. Children were followed for 66 (range 8-109) months; eight of 41 died of HIV-1 related diseases. The cumulative proportion of children with cardiac manifestations at age of seven years was 14.9% (95% CI: 4.9-31.5%). Cardiac abnormalities were detected in eight of 41 patients (19.5%) and were more significantly (p=0.003) recorded in children who died of HIV-1 related diseases (five of eight, 62.5%). Left ventricular systolic function was normal in most patients during the follow-up and did not depend on zidovudine treatment. Two patients had a severe dilated cardiomyopathy and underwent subsequently a stable regression as far as the clinical and instrumental frame was concerned. Only one patient died because of cardiac disease. We conclude that in our group ofperinatally HIV- 1 infected children, cardiac involvement is relatively rare, represents a late complication compared to other related HIV-1 diseases and occurs in advanced stages of illness. Cardiac disease is therefore a hallmark of poor prognosis, but is rarely the ultimate cause of death.

Keywords

Perinatal HIV-1 infectioncardiac manifestationsfollow-upechocardiographyzidovudine
Type
Original Manuscripts
Information
Cardiology in the Young , Volume 6 , Issue 2 , April 1996 , pp. 143 - 148
Copyright
Copyright © Cambridge University Press 1996

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