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pediatric cardiomyopathy hiv

Robert E Shaddy, Aneesh Thomas George, Thomas Jaecklin, Eimear Nic Lochlainn, Lalit Thakur, Rumjhum Agrawal, Susan Solar-Yohay, Fabian Chen, Joseph W Rossano, Thomas Severin, Michael Burch
While the epidemiology of adult heart failure has been extensively researched, this systematic review addresses the less well characterized incidence and prevalence of pediatric HF. The search strategy used Cochrane methodology and identified 83 unique studies for inclusion. Studies were categorized according to whether the HF diagnosis was reported as primary (n = 10); associated with other cardiovascular diseases (CVDs) (n = 49); or associated with non-CVDs (n = 24). A narrative synthesis of the evidence is presented...
March 2018: Pediatric Cardiology
Julius A Ogeng'o, Patrick M Gatonga, Beda O Olabu, Diana K Nyamweya, Dennis Ong'era
BACKGROUND: Heart failure in children is a common cause of morbidity and mortality, with high socio-economic burden. Its pattern varies between countries but reports from Africa are few. The data are important to inform management and prevention strategies. OBJECTIVE: To describe the pattern of congestive heart failure in a Kenyan paediatric population. METHODS: This was a retrospective study done at Kenyatta National Hospital, Nairobi Kenya...
May 2013: Cardiovascular Journal of Africa
Kunjal Patel, Russell B Van Dyke, Murray A Mittleman, Steven D Colan, James M Oleske, George R Seage
OBJECTIVE: Previous studies of cardiomyopathy among children perinatally infected with HIV were conducted before the routine use of HAART. Nucleoside analogs [nucleoside reverse transcriptase inhibitors (NRTIs)], the backbone of HAART, have been associated with mitochondrial toxicity, which can lead to cardiomyopathy. We evaluated the association of HAART and specific NRTIs associated with mitochondrial toxicity, on development of cardiomyopathy among perinatally HIV-infected children...
October 23, 2012: AIDS
D Heather Watts, Sharon Huang, Mary Culnane, Kathleen A Kaiser, Angela Scheuerle, Lynne Mofenson, Kenneth Stanley, Marie-Louise Newell, Laurent Mandelbrot, Jean-Francois Delfraissy, Coleen K Cunningham
OBJECTIVE: To determine rate of and risk factors for birth defects in infants born to HIV-infected women receiving nucleoside and protease inhibitor antiretroviral (ARV) therapy. METHODS: Birth defects were evaluated among infants on the Pediatric AIDS Clinical Trials Group 316 trial that studied addition of peripartum nevirapine to established ARV regimen for prevention of mother-to-child transmission. Maternal therapy was categorized by trimester of earliest exposure...
March 2011: Journal of Perinatal Medicine
S Guillén, L García San Miguel, S Resino, J M Bellón, I González, S Jiménez de Ory, M A Muñoz-Fernández, M L Navarro, M D Gurbindo, M I de José, M J Mellado, P Martín-Fontelos, M I Gonzalez-Tomé, J Martinez, J Beceiro, M A Roa, J T Ramos
OBJECTIVES: Highly active antiretroviral therapy (HAART) has dramatically changed the natural history of HIV infection in children, but there are few studies in the literature about the incidence of clinical manifestations after HAART in this population, compared with adults. The aim of this study was to describe the influence of the widespread use of HAART on the development of opportunistic infections and organ-specific diseases in HIV-infected children. METHODS: An observational study of a cohort of 366 vertically HIV-infected children followed from 1990 to 2006 was carried out...
April 2010: HIV Medicine
Ramachandran Meenakshisundaram, Shah Sweni, Ponniah Thirumalaikolundusubramanian
Cardiac involvement in children with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) is known but less often considered. Our objectives were to determine cardiac manifestations in pediatric HIV/AIDS and estimate the cardiac isoform of alpha-2 macroglobulin [CA2M] among them. We recruited 67 pediatric HIV/AIDS patients, 37 with cardiac involvement (group A) and 30 without (group B); 30 cardiac patients without HIV infection (group C); and 30 healthy control subjects without any comorbid illness (group D)...
February 2010: Pediatric Cardiology
Graciela Quijano, Ricardo Drut
Several types of cardiovascular lesions may develop in pediatric human immunodeficiency virus-positive (HIV+)/acquired immunodeficiency syndrome (AIDS) patients, namely myocarditis, dilated cardiomyopathy, pericardial effusion, pericarditis, left ventricle hypertrophy, fibrocalcific arteriopathy, and aneurysms. Additional lesions may be discovered by histological examination. These include fibrocalcific lesions in medium-sized arteries and small vessels, mainly of the heart and brain, and vasculitis. In the large arteries the vasa vasorum may present chronic inflammatory infiltrates or leukocytoclastic vasculitis, resulting in aneurysms...
November 2006: Pediatric and Developmental Pathology
S Lubega, G W Zirembuzi, P Lwabi
BACKGROUND: There are very few published studies of heart disease in HIV infected children living in sub-Saharan Africa, a region with more than 50% of the world's population of HIV infected patients. OBJECTIVES: To determine the prevalence, and describe the type and clinical presentation of heart disease among children with HIV attending an ambulatory clinic. METHODOLOGY: Two hundred and thirty (230) HIV infected children attending the Paediatric Infectious Disease Clinic at Mulago hospital were recruited by simple random sampling in a cross-sectional study...
September 2005: African Health Sciences
Stacy D Fisher, Kirk A Easley, E John Orav, Steven D Colan, Samuel Kaplan, Thomas J Starc, J Timothy Bricker, Wyman W Lai, Douglas S Moodie, George Sopko, Steven E Lipshultz
BACKGROUND: Many HIV-infected children die with cardiac abnormalities. We sought to understand the course of these HIV-associated abnormalities and their impact on all-cause mortality. METHODS: We describe longitudinal changes in left ventricular (LV) structure and function and mortality in 185 children vertically infected with HIV. Serial cardiac data were obtained from 0.1 to 10 years of age. Age- or body surface area-adjusted z scores were calculated for 10 echocardiographic outcomes...
September 2005: American Heart Journal
J Angdisen, V D G Moore, J M Cline, R M Payne, J A Ibdah
Mitochondrial trifunctional protein (MTP) is a complex protein that catalyzes the last three steps of long chain fatty acid oxidation. MTP defects have emerged recently as important inborn errors of metabolism because of their clinical implications. These disorders are recessively inherited and display a spectrum of clinical phenotypes in affected children including hepatic dysfunction, cardiomyopathy, neuro-myopathy, and may cause sudden unexpected infant death if undiagnosed and untreated. Interestingly, mothers who carry fetuses with MTP defects develop life-threatening complications during pregnancy...
March 2005: Current Drug Targets. Immune, Endocrine and Metabolic Disorders
Karolina M Zareba, Jill E Lavigne, Steven E Lipshultz
Over the past decade, the course of human immunodeficiency virus (HIV) infection has been markedly altered by highly active antiretroviral therapy (HAART). As advances in early diagnosis and aggressive therapy, as well as better supportive care, become available to more HIV-infected patients, survival is being prolonged and more patients are experiencing cardiac abnormalities. Cardiovascular manifestations of pediatric HIV infection have especially proven to be an ongoing challenge to practicing physicians, who face cardiac abnormalities ranging from asymptomatic cardiomyopathy to severe heart failure...
2004: Cardiovascular Toxicology
Jill E Lavigne, William T Shearer, Bruce Thompson, E John Orav, Thomas J Starc, Steven D Colan, Ricardo Pignatelli, Sharon E O'Brien, Louis Bezold, Phillip LaRusa, Kirk A Easley, Irene Cheng, Sarah A Duffy, Steven E Lipshultz
Seroreverters (uninfected children of HIV-infected mothers) have exhibited left ventricular (LV) dysfunction. Mitochondrial toxicity associated with in utero or postnatal exposure to highly active antiretroviral therapy (HAART) is a possible mechanism. Adult and animal models have demonstrated associations between LV abnormalities, cardiomyopathy, and components of HAART. Yet, outcomes in children are poorly understood. In this study, we explore HAART-associated LV abnormalities in seroreverters exposed to HAART (n = 144) or never exposed (n = 252)...
2004: Cardiovascular Toxicology
William G. Harmon, Gul H. Dadlani, Stacy D. Fisher, Steven E. Lipshultz
Cardiovascular complications are frequently encountered in the HIV-infected population. Cardiac care providers should implement appropriate preventive, screening, and therapeutic strategies to maximize survival and quality of life in this increasingly treatable, chronic disease. All HIV-infected individuals should undergo periodic cardiac evaluation, including echocardiography, in order to identify subclinical cardiac dysfunction. Left ventricular (LV) dysfunction can result from, or be exacerbated by, a variety of treatable infectious, endocrine, nutritional, and immunologic disorders...
December 2002: Current Treatment Options in Cardiovascular Medicine
Hal B Jenson, Charles J Gauntt, Kirk A Easley, Jane Pitt, Steven E Lipshultz, Kenneth McIntosh, William T Shearer
In a matched case-control study of the association between coxsackieviruses and cardiac impairment, 24 human immunodeficiency virus (HIV) type 1-infected children with cardiac impairment were compared with 24 HIV-1-infected control subjects. Serologic evidence of coxsackievirus infection was present in all children, with no significant difference in geometric mean antibody titers between case patients and control subjects. Conditional logistic regression to test for an association between coxsackievirus antibody titer and the presence or absence of cardiac impairment, by any indicator, showed an odds ratio of 1...
June 15, 2002: Journal of Infectious Diseases
M J Keesler, S D Fisher, S E Lipshultz
Cardiac manifestations of HIV infection in children are common, but etiologies, contributing factors, and the natural history are largely unexplored. The Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted Human Immunodeficiency Virus Infection Study (P2C2 HIV Study) was initiated in 1989 by the National Heart, Lung and Blood Institute, USA. A primary objective of this study is to examine the epidemiology of cardiovascular problems associated with HIV infection in a cohort of children vertically infected...
November 2001: Annals of the New York Academy of Sciences
N E Bowles, D L Kearney, J Ni, A R Perez-Atayde, M W Kline, J T Bricker, N A Ayres, S E Lipshultz, W T Shearer, J A Towbin
OBJECTIVES: The aim of this study was to investigate the frequency of viral nucleic acid detection in the myocardium of human immunodeficiency virus (HIV)-infected children to determine whether an association exists with the development of heart disease. BACKGROUND: As improved medical interventions increase the life expectancy of HIV-infected patients, increased incidences of myocarditis and dilated cardiomyopathy (DCM) are becoming more apparent, even in patients without clinical symptoms...
September 1999: Journal of the American College of Cardiology
M Culnane, M Fowler, S S Lee, G McSherry, M Brady, K O'Donnell, L Mofenson, S L Gortmaker, D E Shapiro, G Scott, E Jimenez, E C Moore, C Diaz, P M Flynn, B Cunningham, J Oleske
CONTEXT: With the success of zidovudine chemoprophylaxis for prevention of perinatal transmission of the human immunodeficiency virus (HIV), an increasing number of HIV-exposed but uninfected children will have in utero exposure to zidovudine and other antiretroviral drugs. OBJECTIVE: To evaluate the long-term effects of in utero exposure to zidovudine vs placebo among a randomized cohort of uninfected children. DESIGN: Prospective cohort study based on data collected during Pediatric AIDS Clinical Trials Group Protocol 076, a perinatal zidovudine HIV prevention trial, and Protocol 219, a long-term observational protocol...
January 13, 1999: JAMA: the Journal of the American Medical Association
S E Lipshultz, K A Easley, E J Orav, S Kaplan, T J Starc, J T Bricker, W W Lai, D S Moodie, K McIntosh, M D Schluchter, S D Colan
BACKGROUND: The frequency of, course of, and factors associated with cardiovascular abnormalities in pediatric HIV are incompletely understood. METHODS AND RESULTS: A baseline echocardiogram (median age, 2.1 years) and 2 years of follow-up every 4 months were obtained as part of a prospective study on 196 vertically HIV-infected children. Age- or body surface area-adjusted z scores were calculated by use of data from normal control subjects. Although 88% had symptomatic HIV infection, only 2 had CHF at enrollment, with a 2-year cumulative incidence of 4...
April 7, 1998: Circulation
K Anuroj, C Pathmanand, V Sueblinvong, C Thisyakorn, P Chotivitayatarakorn
Nine pediatric symptomatic patients infected with human immunodeficiency virus with elevated pulmonary arterial pressure (MPA pressure) and ejection fraction (EF); and with fractional shortening, (FS) mean velocity of circumferential fiber shortening (MVCfc) and left ventricular peak systolic wall stress (PS) were prospectively evaluated using 2-dimensional and M-mode serial echocardiography and Doppler cardiography after administration of an ACE inhibitor (Inhibace 0.025 mg/kg/D orally) for 12 weeks. The MPA pressure was not decreased, however the MVCfc and PS improved significantly (p < 0...
June 1997: Southeast Asian Journal of Tropical Medicine and Public Health
V V Joshi
Acquired Immunodeficiency Syndrome (AIDS) was first described to occur in children in 1983. With experience of increasing number of cases of AIDS, pathologic lesions in various organs and tissues such as lungs, brain, G.I. tract, heart, blood vessels, lymph nodes, spleen, bone marrow, etc. became evident in autopsy and biopsy specimens. These pathologic lesions were classified into four groups based on known or suspected pathogenesis: 1) Primary lesions due to Human Immunodeficiency (HIV) infection itself (lymph nodes, brain, etc) 2) associated lesions related to direct or indirect sequelae of HIV infection (Opportunistic infections, PLH/LIP complex, etc) 3) lesions of undetermined pathogenesis, (cardiomyopathy, arteriopathy, thrombocytopenia, nephropathy, etc) 4) lesions of multifactorial pathogenesis (villous atrophy of intestine, thymic lesions, etc)...
December 1996: Keio Journal of Medicine
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