Perinatal ventricular dysfonction in HIV infection

We studied cardiovascular function in four babies . There were three females (3, 6 and 9 months old ) and one 6 months old male with HIV perinatal infection (ELISA and Western blot positives). CD4 counts were: 1150/mm3, 1250 /mm3, 950/mm3 and 1066/mm3 respectively. The first baby had pneumocystosis and oral candidiasis, and two other had bacterial pneumonia and viral brochiolitis as antecedents. We observed after echocardiographic Doppler evaluation right ventricle diastolic dysfunction in three cases. Interestingly there were no pulmonary hypertension. Diastolic and systolic left ventricle function was normal in all babies. Our previous results in 27 AIDS adult patients let us to identify mainly left ventricle dysfunction (Valdes E & al Prensa Medica Argentina 1994). On the contrary, right ventricle dysfunction was predominant in this small series. Lipshultz & al (Am J Cardio 1990) found in 31 perinatal AIDS ventricular dysfunction, myocardial dilatation, arrhythmias and pericardial effusion. Our results combined with a literature review point out cardiac dysfunction as a frequent finding in children with AIDS. As these alterations are not necessarily clinically apparent, we recommend routine echocardiographic evaluation in these patients. Physiopathological clues in AIDS cardiac dysfunction remain elusive: HIV cytotoxic myocardiopathy, opportunistic infections and/or viral autoimmune mechanisms have been considered as potential causes