Antiviral Medication Alters Heart Function in Children With HIV

While combination regimens could have cardioprotective effects in children with perinatally acquired HIV infection, the individual antiretroviral medications can alter cardiac structure, according to a new study.

This alteration can mean symptomatic cardiomyopathy in adulthood, the researchers say.

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There were 325 children with perinatally acquired HIV enrolled in the multi-site cohort study. To evaluate cardiac function and structure, they each were administered a single echocardiogram between age 7 and 16 years. The researchers then evaluated associations between the use of 18 individual antiretroviral medications with the Z-scores for 11 measures of left ventricular function and structure.

The researchers discovered that the children who were taking combination regimens with a protease inhibitor (69%) had significantly better cardiac function than those on other regimens.

“After [false discovery rate] control and adjustment for other antiretroviral medications, no individual antiretroviral medication was significantly associated with any measure of left ventricular function, but zidovudine was associated with higher adjusted mean Z-scores for one measure of left ventricular structure (end-systolic wall stress),” the researchers wrote.

While lopinavir was associated with better heart function scores, zidovudine was associated with higher wall stress scores. Zidovudine was also associated with higher heart size factor scores, as was nevirapine.

—Colleen Murphy

Reference:

Williams PL, Correia K, Karalius B, et al; Pediatric HIV/AIDS Cohort Study. Cardiac status of perinatally HIV-infected children: assessing combination antiretroviral regimens in observational studies. AIDS Soc. 2018;32(16):2337-2346. doi:10.1097/QAD.0000000000001988.