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Before the use of today’s
antiretroviral therapy (ART), children with HIV infection were more likely to
have abnormalities in the left ventricular structure and function that
increased their risk of death. Highly Active Antiretroviral therapy (HAART)
appears to preserve cardiac function, but the interactions between HIV, ART,
and cardiac function is unclear. Steven Lipshultz, MD of the University of
Miami and colleagues investigated the effect of long-term HAART on cardiac
function. The researchers compared three cohorts—two from the Adolescent Master
Protocol of the Pediatrics HIV/AIDS Cohort Study (PHACS) and one from the
Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV
Infection Study.
The PHACS study was conducted at 14
pediatric HIV clinics in the United States from March 2007 to November 2009
with children aged 7 to 16 years. The researchers reviewed data from 325
children in the PHACS study with perinatal HIV infection who were receiving
HAART, which means treatment with at least three ART drugs from at least two
ART drug classes and 189 children who were exposed to HIV, but were not
infected. Also, researchers reviewed data from the Pulmonary and Cardiovascular
Complications (PCHIV) study, which was conducted from 1990 to 1997. They examined
data from 70 children from the PCHIV study who were infected with HIV, but were
not treated with HAART. All children received echocardiograms.
Compared with HIV-infected youth
treated when HAART was not widely used, those mostly treated with HAART had
significantly better echocardiographic measures of heart structure and
function. Some of the patients from the earlier cohort (PCHIV study), but none
of the newer cohort (PHACS study) developed clinical heart disease. The authors
concluded that findings suggest an overall cardio protective effect of
long-term HAART, but the reasons for this effect are not clear.
The full report, “Cardiac Status of
Children Infected With Human Immunodeficiency Virus Who Are Receiving Long-term
Combination Antiretroviral Therapy: Results From the Adolescent Master Protocol
of the Multicenter Pediatric HIV/AIDS Cohort Study,” was published online in
the journal JAMA Pediatrics (doi:10.1001/jamapediatrics.2013.1206).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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