Most pediatric patients with HIV are infected in the perinatal period. In a prospective, longitudinal, multi center study, diagnostic echo cardiograms were performed at 4- to 6-month intervals on two cohorts of children exposed to maternal HIV-1 infection: (a) a neonatal cohort of 90 HIV infected, 449 HIV-uninfected, and 19 HIV-indeterminate children; and (b) an older HIV-infected cohort of 201 children with vertically transmitted HIV-1 infection recruited after 28 days of age.
In the neonatal cohort, 36 lesions were seen in 36 patients, yielding an overall congenital cardiovascular malformation prevalence of 6.5% (36/558), with an 8.9% (8/90) prevalence in HIV-infected children and a 5.6% (25/449) prevalence in HIV-uninfected children [3]. Two children (2/558, 0.4%) had cyanotic lesions. In the older HIV-infected cohort, there was a congenital cardiovascular mail information prevalence of 7.5% (15/201). The distribution of lesions did not differ significantly
between the groups. There was no statistically significant difference in congenital cardiovascular
malformation prevalence in the HIV-infected compared to the HIV-uninfected children born to HIV-infected women. With the use of early screening echo cardiography, rates of congenital cardiovascular malformations in both the HIV-infected and HIV-uninfected children were five- to tenfold higher than rates reported in population-based epidemiologic studies, but not higher than in normal populations similarly screened.
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