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dc.contributor.authorMajonga, Edith D.
dc.contributor.authorRehman, Andrea M.
dc.contributor.authorSimms, Victoria
dc.contributor.authorMcHugh, Grace
dc.contributor.authorMujuru, Hilda A.
dc.contributor.authorNathoo, Kusum
dc.contributor.authorOdland, Jon Øyvind
dc.contributor.authorPatel, Mohammad S.
dc.contributor.authorKaski, Juan P.
dc.contributor.authorFerrand, Rashida A.
dc.date.accessioned2022-04-27T07:29:45Z
dc.date.available2022-04-27T07:29:45Z
dc.date.issued2018-11-28
dc.description.abstractBackground: Antiretroviral therapy (ART) has decreased mortality so that increasing numbers of children with HIV are reaching adolescence. However, longstanding HIV infection and/or its treatment in children is associated with noninfectious complications including cardiac disease. We investigated the prevalence, spectrum and risk factors for echocardiographic abnormalities among children established on ART.<p> <p>Methods: HIV-infected children aged 6–16 years, on ART at least 6 months were enrolled into a cross-sectional study from a public-sector paediatric HIV clinic in Harare, Zimbabwe. A standardized examination including transthoracic echocardiography was performed. Local echocardiographic reference ranges were used to define cardiac abnormalities. Logistic regression was used to examine the association between cardiac abnormalities and risk factors.<p> <p>Results: Of the 201participants recruited, 92 (46%) were girls and median age was 11 (IQR 9–12) years; CD4þ cell count was 727 cells/ml (IQR 473–935) and 154 (78%) had viral load less than 400 copies/ml. Echocardiographic abnormalities were found in 83 (42%); left ventricular (LV) diastolic dysfunction was the most common abnormality 45 (23%) and LV hypertrophy in 22 (11%). LV and left atrial dilatation were found in 9 (5%) and 16 (8%), respectively. Right ventricular dilatation and systolic dysfunction were found in 13 (7%) and 4 (2%), respectively, of whom 60% had concurrent left heart abnormalities. Current use of nevirapine was associated with LVH [aOR 3.14 (1.13– 8.72; P ¼ 0.03)] and hypertension was associated with LV diastolic dysfunction [aOR 3.12 (1.48–6.57; P < 0.01)].<p> <p>Conclusion: HIV-infected children established on ART have a high burden of echocardiographic abnormalities. Right heart disease was predominantly associated with left heart abnormalities and may be part of a global cardiomyopathic process. Further studies are needed to investigate the natural history, aetiology, and pathogenesis of these abnormalities, so that appropriate monitoring and treatment strategies can be developed.en_US
dc.identifier.citationMajonga ED, Rehman AM, Simms V, McHugh G, Mujuru HA, Nathoo K, Odland j, Patel MS, Kaski JP, Ferrand RA. High prevalence of echocardiographic abnormalities in older HIV-infected children taking antiretroviral therapy. AIDS (London). 2018;32(18):2739-2748en_US
dc.identifier.cristinIDFRIDAID 1622106
dc.identifier.doi10.1097/QAD.0000000000002031
dc.identifier.issn0269-9370
dc.identifier.issn1473-5571
dc.identifier.urihttps://hdl.handle.net/10037/24898
dc.language.isoengen_US
dc.publisherWolters Kluweren_US
dc.relation.journalAIDS (London)
dc.relation.projectIDNorges forskningsråd: 234424en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2018 The Author(s)en_US
dc.titleHigh prevalence of echocardiographic abnormalities in older HIV-infected children taking antiretroviral therapyen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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