CARDIAC DISEASE IN CHILDREN WITH HIV - RELATIONSHIP OF CARDIAC DISEASE TO HIV SYMPTOMATOLOGY

The relationship of cardiac disease to the Centers for Disease Control and Prevention (CDC) classification for human immunodeficiency virus (HIV)-infected children was examined by retrospective chart review. Th e children (n = 95) were diagnosed at an urban children's hospital bet ween 1989 and 1992. Children ranged in age from 4 months to 12 years, were followed for an average of 10 months (range 1-24 months), and had an average of 2.6 cardiac studies (range 1-7). Children with transfus ion or transplantation-acquired HIV were excluded. Children were divid ed into asymptomatic P1 (n = 15) and symptomatic P2 (n = 80) classes. Electrocardiographic (ECG) and echocardiographic (Echo) studies were d one in all children. Antiviral drug therapy was used in 3 (20%) of 15 children in the PI group and 56 (70%) of 80 children in the P2 group. No significant ECG or Echo abnormalities were noted in the PI group. I ncreased, left ventricular contractility was present in 3 (20%) of 15 children. Of the P2 group, 36 (45%) of 80 children had either ECG abno rmalities, Echo abnormalities, or both. Increased contractility was pr esent in an additional 15 (19%) of 80 children. Deaths occurred only i n the P2 group of children and ECG or Echo abnormalities occurred in 1 1 of 12 children who died (p < 0.005). There is a progression of cardi ac abnormalities in HIV-infected children that corresponds to their P status, and cardiac disease is associated with morbidity and mortality in these children.