PREVALENCE OF CONGENITAL CARDIOVASCULAR MALFORMATIONS IN CHILDREN OF HUMAN IMMUNODEFICIENCY VIRUS-INFECTED WOMEN - THE PROSPECTIVE P(2)C(2)HIV MULTICENTER STUDY

Objectives. The purpose of the study was to assess the effects of mate rnal HIV-1 (human immunodeficiency virus) infection and vertically tra nsmitted HIV-1 infection on the prevalence of congenital cardiovascula r malformations in children. Background In the United States, an estim ated 7000 children are born to HIV-infected women annually. Previous l imited reports have suggested an increase in the prevalence of congeni tal cardiovascular malformations in vertically transmitted HIV-infecte d children. Methods. In a prospective longitudinal multicenter study, diagnostic echocardiograms were performed at 4-6-month intervals on tw o cohorts of children exposed to maternal HIV-1 infection: 1) a Neonat al Cohort of 90 HIV-infected, 449 HIV-uninfected and 19 HIV-indetermin ate children; and 2) an Older HIV-Infected Cohort of 201 children with vertically transmitted HIV-1 infection recruited after 28 days of age . Results. In the Neonatal Cohort, 36 lesions were seen in 36 patients , yielding an overall congenital cardiovascular malformation prevalenc e of 6.5% (36/558), with a 8.9% (8/90) prevalence in HIV-infected chil dren and a 5.6% (25/449) prevalence in HIV-uninfected children. Two ch ildren (2/558, 0.4%) had cyanotic lesions. In the Older HIV-Infected C ohort, there was a congenital cardiovascular malformation prevalence o f 7.5% (15/201). The distribution of lesions did not differ significan tly between the groups. Conclusions. There was no statistically signif icant difference in congenital cardiovascular malformation prevalence in HIV-infected versus HIV-uninfected children born to HIV-infected wo men. With the use of early screening echocardiography, rates of congen ital cardiovascular malformations in both the HIV-infected and HIV-uni nfected children were five- to ten-fold higher than rates reported in population-based epidemiologic studies but not higher than in normal p opulations similarly screened. Potentially important subclinical conge nital cardiovascular malformations were detected. (J Am Cell Cardiol 1 998;32:1749-55) (C) 1998 by the American College of Cardiology.