1. Cardiac, aortic, and pulmonary arteriopathy in HIV-infected children: the Prospective P2C2 HIV Multicenter Study.
- Author
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Perez-Atayde AR, Kearney DI, Bricker JT, Colan SD, Easley KA, Kaplan S, Lai WW, Lipshultz SE, Moodie DS, Sopko G, and Starc TJ
- Subjects
- Aorta pathology, Aortic Diseases complications, Aortic Diseases pathology, Cadaver, Child, Child, Preschool, Chronic Disease, Coronary Disease complications, Coronary Disease diagnostic imaging, Coronary Disease pathology, Coronary Vessels pathology, Echocardiography, Female, HIV Infections immunology, Heart Diseases complications, Humans, Immune Tolerance, Infant, Newborn, Male, Prospective Studies, Vascular Diseases complications, Vascular Diseases pathology, Aortic Diseases virology, Coronary Disease virology, HIV Infections complications, Pulmonary Artery pathology, Vascular Diseases virology
- Abstract
Arteriopathy in human immunodeficiency virus (HIV)-infected patients is being increasingly recognized, especially in children. However, few studies have histologically evaluated the coronary arteries in HIV-infected children, and none have systematically assessed the aorta and pulmonary arteries. The coronary arteries, thoracic aorta, and the main and branch pulmonary arteries from the postmortem hearts of 14 HIV-infected children were systematically reviewed for vasculopathic lesions and compared with 14 age-matched controls. Findings from the HIV-infected children were compared with clinical, laboratory, and other postmortem findings. Coronary arteriopathy, seen in seven (50%) of the HIV-infected children, was primarily calcific, and it was associated with decreased CD3 and CD4 peripheral blood counts. Large vessel arteriopathy, seen in 9 (64%) of the 14 HIV-infected children, was primarily centered on the vasa vasorum and consisted mainly of medial hypertrophy and chronic inflammation. Large vessel lesions were associated with increased left ventricular mass z-scores (P = 0.02), and 78% of patients with large vessel arteriopathy had postmortem cardiomegaly. Coronary and large vessel arteriopathies are common in pediatric HIV-infection and have different clinicopathologic features suggesting different pathogenesis.
- Published
- 2004
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