Assessment of Asymptomatic Heart Disease in Children With HIV
Assessment of Asymptomatic Heart Disease in Children With HIV
The purpose of this study is to perform cardiac evaluation in HIV-1 (predominantly clade
 C)infected children by history, physical examination, echocardiogram and plasma N-terminal
 pro-B-type natriuretic peptide (N-BNP)measurement in order to determine asymptomatic
 abnormalities.
Human immunodeficiency virus (HIV) infection affects nearly 40 million adults and children
 worldwide. Recently introduced new antiviral drugs have significantly improved survival of
 patients with HIV infection. As mortality declines, morbidity becomes a concern. Heart
 disease is present in 20% of children and adults with HIV. The cardiac diseases include left
 ventricular dysfunction, hypertrophy and dilation, pericardial effusion and intracardiac
 masses. Cardiac disease is an independent risk factor for death in these children. The
 reported two-year survival of children with congestive heart failure is zero compared to 17%
 when no heart failure is present. It is thus indicated to perform periodic cardiac
 examinations in these patients, and early recognition of cardiac disease is paramount.

 In addition to the traditional tools to assess cardiac status which include history, physical
 examination, ECG, chest X-ray and echocardiography, we propose to check biochemical markers.
 Brain natriuretic peptide has been shown to be a very sensitive marker for symptomatic and
 asymptomatic cardiac dysfunction, prognosis, severity of the disease and response to therapy
 in adults. Troponin-T is a very good marker for cardiac ischemia. Recently, we have found
 troponin-T to be a good marker for acute cardiac insult in infants and children.

 The aim of this study is to perform screening of children with HIV predominantly clade C for
 cardiac disease using the above mentioned means.
Inclusion Criteria:

 -  Infants and children congenitally infected with HIV-1