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Long-term combination ART cardioprotective in children, adolescents
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Long-term use of highly active antiretroviral therapy for HIV-infected children and adolescents appears to be cardioprotective, according to study results published in JAMA Pediatrics.
“Children with more severe HIV disease appear to experience more serious adverse effects on cardiac structure and function,” researchers wrote. “Our results indicate that the current use of combination ART, usually highly active ART, appears to be cardioprotective in HIV-infected children and adolescents.”
The study included 325 HIV-infected children receiving HAART and 189 HIV-exposed but uninfected children from the NIH-funded Pediatric HIV/AIDS Cohort Study’s Adolescent Master Protocol (AMP) and 70 HIV-infected controls from the NIH-funded Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection (P2C2-HIV) study.
Researchers found that the AMP HIV-infected participants had lower viral loads, higher CD4 counts, and longer durations of ART than participants from P2C2-HIV (all P<.001).
According to researchers, z scores for left ventricular fractional shortening were significantly lower among HIV-infected participants from the P2C2-HIV Study than the AMP HIV-infected group and AMP HIV-exposed but uninfected participants (P<.05).
Researchers also found that HIV-infected participants with a lower nadir CD4 percentage and a higher current viral load were associated with significantly lower cardiac function (P=.001) and an increased left ventricular end-systolic dimension z score (P<.03). AMP HIV-infected participants had relatively constant mean left ventricular fractional shortening z scores; however, HIV-infected participants from the P2C2-HIV Study with a longer ART exposure or a lower nadir CD4 percentage also had lower mean z score (P<.05).
“Examining the associations between individual ART agents and combinations of ART might identify optimal ART regimens, both in terms of optimizing HIV outcomes and protecting long-term cardiac health and represents a future research opportunity using this data set,” researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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