ArticleAIDS (London, England)2018
High prevalence of echocardiographic abnormalities in older HIV-infected children taking antiretroviral therapy.
Article in AIDS (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Prevalence of left ventricular systolic dysfunction in HIV-infected children from sub-saharan Africa: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Unsuppressed Viremia and Lower CD4 Count Associated With Faster Telomere Attrition in African Children With Perinatal Human Immunodeficiency Virus on Long-term Antiretroviral Therapy.The Journal of infectious diseases · 2026Trial
- HIV and Cardiovascular Disease Burden in Young Adults (18-25 years): A Review of Current Evidence.Current atherosclerosis reports · 2025Review
- Cardiometabolic Health Burden in Pediatric HIV: Unmet Need in the Contemporary Antiretroviral Therapy Era.Cureus · 2025Review
- Cardioprotective effects of early versus late initiated antiretroviral treatment in adolescents with perinatal HIV-1 infection.Scientific reports · 2024Article
- An interprofessional model of care for adolescents with perinatal HIV: A qualitative study.Health science reports · 2024Article
- The burden and natural history of cardiac pathology at TB diagnosis in a high-HIV prevalence district in Zambia: protocol for the TB-Heart study.BMC cardiovascular disorders · 2024Article
- Asymptomatic people with well-controlled HIV do not have abnormal left ventricular global longitudinal strain.Frontiers in cardiovascular medicine · 2023Article
- Article
- The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial.International journal of cardiology. Heart & vasculature · 2021Article
- Cardiometabolic Complications in Youth With Perinatally Acquired HIV in the Era of Antiretroviral Therapy.Current HIV/AIDS reports · 2021Review
- Comparison of index-linked HIV testing for children and adolescents in health facility and community settings in Zimbabwe: findings from the interventional B-GAP study.The lancet. HIV · 2021Article
- Carotid intima media thickness in older children and adolescents with HIV taking antiretroviral therapy.Medicine · 2020Observational
- Incidence and Progression of Echocardiographic Abnormalities in Older Children with Human Immunodeficiency Virus and Adolescents Taking Antiretroviral Therapy: A Prospective Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Multisystem impairment in South African adolescents with Perinatally acquired HIV on antiretroviral therapy (ART).Journal of the International AIDS Society · 2019Article
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Authors and funding
10 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundAntiretroviral therapy (ART) has decreased mortality so that increasing numbers of children with HIV are reaching adolescence. However, longstanding HIV infection and/or its treatment in children is associated with noninfectious complications including cardiac disease. We investigated the prevalence, spectrum and risk factors for echocardiographic abnormalities among children established on ART.
methodsHIV-infected children aged 6-16 years, on ART at least 6 months were enrolled into a cross-sectional study from a public-sector paediatric HIV clinic in Harare, Zimbabwe. A standardized examination including transthoracic echocardiography was performed. Local echocardiographic reference ranges were used to define cardiac abnormalities. Logistic regression was used to examine the association between cardiac abnormalities and risk factors.
resultsOf the 201participants recruited, 92 (46%) were girls and median age was 11 (IQR 9-12) years; CD4+ cell count was 727 cells/μl (IQR 473-935) and 154 (78%) had viral load less than 400 copies/ml. Echocardiographic abnormalities were found in 83 (42%); left ventricular (LV) diastolic dysfunction was the most common abnormality 45 (23%) and LV hypertrophy in 22 (11%). LV and left atrial dilatation were found in 9 (5%) and 16 (8%), respectively. Right ventricular dilatation and systolic dysfunction were found in 13 (7%) and 4 (2%), respectively, of whom 60% had concurrent left heart abnormalities. Current use of nevirapine was associated with LVH [aOR 3.14 (1.13-8.72; P = 0.03)] and hypertension was associated with LV diastolic dysfunction [aOR 3.12 (1.48-6.57; P < 0.01)].
conclusionHIV-infected children established on ART have a high burden of echocardiographic abnormalities. Right heart disease was predominantly associated with left heart abnormalities and may be part of a global cardiomyopathic process. Further studies are needed to investigate the natural history, aetiology, and pathogenesis of these abnormalities, so that appropriate monitoring and treatment strategies can be developed.
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