| Cardiac effects of antiretroviral therapy in HIV-negative infants born to HIV-positive mothers: NHLBI CHAART-1 (National Heart, Lung, and Blood Institute Cardiovascular Status of HAART Therapy in HIV-Exposed Infants and Children cohort study). | |
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MedLine Citation:
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PMID: 21185505 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of this study was to investigate the possible effects of antiretroviral therapy (ART) in utero on cardiac development and function in human immunodeficiency virus (HIV)-negative children. BACKGROUND: ART reduces vertical HIV transmission. Long-term cardiotoxicity after in utero exposure to ART is unknown in children but has occurred in young animals. METHODS: Using a prospective multisite cohort study design, echocardiograms taken between birth and 24 months were compared in 2 groups of HIV-negative infants of HIV-positive mothers: 136 infants exposed to ART (ART+) and 216 unexposed infants (ART-). RESULTS: Mean left ventricular (LV) mass z-scores were consistently lower in ART+ girls than in ART- girls: differences in mean z-scores were -0.46 at birth (p = 0.005), -1.02 at 6 months (p < 0.001), -0.74 at 12 months (p < 0.001), and -0.79 at 24 months (p < 0.001). Corresponding differences in z-scores for boys were smaller: 0.13 at 1 month (p = 0.42), -0.44 at 6 months (p = 0.01), -0.15 at 12 months (p = 0.37), and -0.21 at 24 months (p = 0.21). Septal wall thickness and LV dimension were smaller than expected in ART+ infants, but LV contractility was consistently about 1 SD higher at all ages (p < 0.001). In ART+ infants, LV fractional shortening was higher than in ART- infants; girls showed a greater difference. CONCLUSIONS: Fetal exposure to ART is associated with reduced LV mass, LV dimension, and septal wall thickness z-scores and increased LV fractional shortening and contractility up to age 2 years. These effects are more pronounced in girls than in boys. Fetal ART exposure may impair myocardial growth while improving depressed LV function. |
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Authors:
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Steven E Lipshultz; William T Shearer; Bruce Thompson; Kenneth C Rich; Irene Cheng; E John Orav; Sulekha Kumar; Ricardo H Pignatelli; Louis I Bezold; Philip LaRussa; Thomas J Starc; Julie S Glickstein; Sharon O'Brien; Ellen R Cooper; James D Wilkinson; Tracie L Miller; Steven D Colan |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 57 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-27 Completed Date: 2011-03-22 Revised Date: 2012-01-05 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 76-85 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida 33101, USA. slipshultz@med.miami.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anti-Retroviral Agents / adverse effects*, therapeutic use Antiretroviral Therapy, Highly Active / adverse effects Child, Preschool Female Follow-Up Studies HIV / immunology* HIV Seropositivity / drug therapy* Heart / drug effects*, embryology Humans Infant Infant, Newborn Infectious Disease Transmission, Vertical Male Maternal Exposure / adverse effects* Pregnancy Pregnancy Complications, Infectious / drug therapy* Prospective Studies Risk Factors Ventricular Function, Left / drug effects* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL072705-01/HL/NHLBI NIH HHS; R01 HL072705-02/HL/NHLBI NIH HHS; R01 HL072705-03/HL/NHLBI NIH HHS; R01 HL072705-04/HL/NHLBI NIH HHS; R01 HL072705-05/HL/NHLBI NIH HHS; R01 HL072705-06/HL/NHLBI NIH HHS; R01 HL72705/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-Retroviral Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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