BACKGROUND A high prevalence of cardiac abnormalities has been reported in children with HIV taking ART in sub-Saharan Africa. We investigated the incidence and progression of cardiac abnormalities among children taking ART in Zimbabwe. METHODS A prospective cohort study was conducted at a paediatric HIV clinic from 2014 to 2017. Children with HIV aged between 6 and 16 years and taking ART ≥6 months were enrolled. Transthoracic echocardiography was performed at baseline and 18 months. RESULTS Of 197 participants recruited at baseline, 175 [(89%), 48% female, median age 12 (IQR, 10-14) years] were followed up. The incidence of left and right heart abnormalities was 3.52 and 5.64 per 100 pys, respectively. Stunting was associated with the development of any cardiac abnormality [adjusted OR 2.59 (95% CI, 1.03-6.49); p=0.043]. Right ventricular (RV) dilatation persisted at follow up in 92% and left ventricular (LV) diastolic dysfunction in 88%. Cardiac abnormalities present at baseline reverted to normal over the follow up period in 11(6%). There was an overall increase in mean z-scores for LV, left atrium (LA), RV, interventricular septum and LV posterior wall diameters at 18 months (p<0.001). CONCLUSIONS Despite ART, children with HIV have a high incidence of cardiac abnormalities, with only a minority being transient. Mean z-scores for LV, LA, RV, interventricular septum and LV posterior wall diameters increased over a relatively short follow up period, suggesting the potential for progression of cardiac abnormalities. Longer follow up is required to understand the clinical implications of these abnormalities.

中文翻译：

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接受抗逆转录病毒治疗的艾滋病毒感染年龄较大儿童和青少年超声心动图异常的发生率和进展：一项前瞻性队列研究。


背景 据报道，在撒哈拉以南非洲地区接受抗逆转录病毒治疗的艾滋病毒感染儿童中，心脏异常的患病率很高。我们调查了津巴布韦接受抗逆转录病毒治疗的儿童心脏异常的发生率和进展情况。方法 2014年至2017年在儿童HIV诊所进行了一项前瞻性队列研究。纳入年龄在6岁至16岁之间且接受ART≥6个月的HIV感染儿童。在基线和 18 个月时进行经胸超声心动图检查。结果 在基线招募的 197 名参与者中，有 175 名[(89%)，其中 48% 为女性，中位年龄 12 (IQR，10-14) 岁]进行了随访。左心和右心异常的发生率分别为 3.52 例/100 pys 和 5.64 例/100 pys。发育迟缓与任何心脏异常的发生有关[调整后 OR 2.59 (95% CI, 1.03-6.49)； p=0.043]。 92% 的患者随访时出现右心室 (RV) 扩张，88% 的患者出现左心室 (LV) 舒张功能障碍。基线时存在的心脏异常在 11 例（6%）的随访期内恢复正常。 18 个月时，左心室、左心房 (LA)、右心室、室间隔和左心室后壁直径的平均 z 分数总体增加 (p<0.001)。结论 尽管进行了抗逆转录病毒治疗，感染艾滋病毒的儿童心脏异常的发生率很高，只有少数是暂时性的。左心室、左心室、右心室、室间隔和左心室后壁直径的平均 z 评分在相对较短的随访期内增加，表明心脏异常有可能进展。需要更长时间的随访才能了解这些异常的临床影响。