Increased risk of heart abnormalities in children born to mothers with HIV-1

A report published on The Lancet website reveals how HIV-1 infection in pregnant women is associated with persistent cardiovascular abnormalities in children shortly after birth. The authors report that, irrespective of their HIV-1 status, children born to HIV-1-infected women have substantially worse cardiac function than other infants.

The scientists, led by Steven Lipshultz of the Golisaon Childrens Hospital, University of Rochester, New York, used echocardiography to measure the cardiovascular function of infants born to HIV-1-infected women every 46 months, for up to five years. The group studied 93 infants infected with HIV-1 from birth, and 463 uninfected children as an internal control.

Additionally, a group of 193 healthy children born to mothers who were not infected with HIV-1 was also included as an external control.

The study showed that children with HIV-1 had a higher heart rate at all ages compared with those in the internal control group, by 10 beats per minute. Furthermore, children born with HIV-1, together with those in the internal control group, had impaired cardiac structure and function up to the age of eight months, after which point there was no difference between children in the internal and external control groups. However, children born with HIV-1 had impaired heart function for the first 20 months of life, as a result of a lack of reduction in size of the left ventricle.

Co-author George Sopko stated that: Differences in the hearts structure and function in uninfected children born to HIV-infected mothers were milder and tended to dissipate over time compared to changes found in HIV-infected children.

Professor Lipshultz concluded: Impaired cardiac structure and function seem related to HIV-1-infection status in children born to women infected with HIV-1. Since LV [left ventricular] dysfunction is found in both infected and uninfected children born to women infected with HIV-1, the dysfunction could be related to the intrauterine environment. These environmental effects could result from HIV-1 and other infections, maternal and postnatal nucleoside analogue and other drug use, maternal nutrition, placental abnormalities, racial and ethnic differences, and mitochondrial dysfunction. He continued: We suggest that continuing follow-up and appropriate treatment strategies should be considered for all children born to women infected with HIV-1.