Important note: Information in this article was accurate in June 2001. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, June 4, 2001
Michael Greer, Staff Medical Writer
NewsRx - Children infected with HIV are at risk for enlargement of the aortic root, a problem becoming more prevalent as new treatments prolong their lives, Mt. Sinai Medical Center researchers warn.
"Vascular lesions have become more evident in [HIV] infected patients as the result of earlier diagnosis, improved treatment, and longer survival," explained W.W. Lai and colleagues at Mt. Sinai Medical Center. However, "[a]ortic root dilation in HIV infected children has not previously been described."
After studying 280 infected children of varying ages, Lai and coworkers found that aortic root enlargement was common although clinical manifestations were limited.
Measurements of the aortic annulus, sinuses of Valsalva, and sinotubular junction showed that the aortic roots of HIV infected 2-year-olds were significantly (P< 0.04) larger than those of their peers, the researchers said. By age 5, the significance of the discrepancy had increased further, with a (Pless than or equal to0.005).
Enlarged aortic roots were associated with similar dilations of the left ventricle, study data showed. Increased levels of HIV RNA and reduced CD4+ cell counts were also linked to higher-than-normal aortic root measurements.
However, dilated aortic roots had little or no effect on blood pressure, heart rate, hematocrit, or hemoglobin concentrations ("Dilation of the aortic root in children infected with human immunodeficiency virus type 1: The Prospective (PCHIV)-C-2-H-2 Multicenter Study," Am Heart J 2001 Apr;141(4):661-70.
"Aortic root size was not significantly associated with markers for stress-modulated growth; however, aortic root dilation was associated with left ventricular dilation, increased viral load, and lower CD4 cell count in HIV infected children," Lai and colleagues concluded. "As prolonged survival of HIV infected patients becomes more prevalent, some patients may require long-term follow-up of aortic root size."
The corresponding author for this report is W.W. Lai, Mt. Sinai Medical Center, Mt. Sinai School of Medicine, Dept. of Pediatrics, Division of Pediatric Cardiology, Box 1201, 1 Gustave L. Levy Place, New York, NY 10029, USA.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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