The babies of HIV-positive mothers are at greater risk of developing heart abnormalities, irrespective of whether they are born infected with HIV, than the infants of HIV-negative mothers, according to an American study published in the 18 June 2002 on-line edition of The Lancet.
In a five year, multi-centre study, investigators from the University of Rochester, New York, compared 600 infants born to HIV-positive mothers to a control population of 195 babies of HIV-negative mothers. Of the babies with HIV-positive mothers, 93 tested HIV-positive, and 463 were HIV-negative, with 44 excluded from the study. The HIV-positive and HIV-negative groups had similar numbers of girls and boys, a comparable racial mix and similar proportion of mothers were engaged in high risk activities, such as smoking or recreational drug use, which are known to be harmful to a baby’s health.
The infants’ cardiac function was monitored every four-to-six months for five years using echocardiography. The babies of HIV-positive mothers, regardless of whether they were infected with the virus or not, had a faster heart rate, with the HIV-positive babies having an average 13 extra beats per minute, and the HIV-negative infants three additional beats per minute. In addition, the babies of HIV-positive mothers had decreased left ventrical functioning, meaning that they were unable to efficiently pump oxygenated blood around their bodies. In HIV-positive babies such cardiac abnormalities have been associated with an increased risk of heart failure and death in infancy.
Investigators noted however that the differences in the heart’s structure and functioning tended to be milder in the HIV-negative infants of HIV-positive mothers and tended to become even milder over time compared to HIV-positive babies.
Interuterine factors are thought by the researchers to be responsible for the heart abnormalities, particularly maternal nutrition and the inflammatory process triggered by HIV.
More research is needed to determine the longer-term cardiovascular health of the offspring of HIV-positive mothers, say the study authors.
Lipshultz S E et al. Cardiovascular status of infants and children of women infected with HIV-1 (P2C2 HIV): a cohort study. Lancet, published online June 18, 2002 (click here to view)