Key result
Perinatal HIV infection shows no difference in LV parameters compared to perinatal HIV exposure.
Why the study?
The long-term cardiac status and changes in cardiac structure and function over 10+ years among young adults with perinatal HIV compared to those perinatally HIV-exposed but uninfected needed evaluation.
Does perinatal HIV infection alter long-term changes in left ventricular structure and systolic function Z-scores compared to perinatal HIV exposure without infection in young adults?
Cohort (n=158)
Does perinatal HIV infection alter long-term changes in left ventricular structure and systolic function Z-scores compared to perinatal HIV exposure without infection in young adults?
Young adults with perinatal HIV infection or exposure showed no progression to greater LV hypertrophy over 10 years, but both groups experienced declines in LV ejection fraction Z-scores that warrant continued cardiac imaging follow-up.
Answers are grounded in this paper and cite their sources.
Both groups warrant ongoing LV surveillance; leaves open whether perinatal HIV confers added long-term risk beyond exposure alone.
OBJECTIVE: To evaluate the cardiac status of young adults with perinatal HIV (PHIV) compared to those perinatally HIV-exposed but uninfected (PHEU), and changes in their cardiac structure and function over 10+ years. DESIGN: United States-based longitudinal study conducted in 2018-2022 in young adults with PHIV or PHEU who had a prior echocardiogram performed 2008-2010. METHODS: Echocardiograms were performed in 158 young adults (99 PHIV, median age 23.9 years; 59 PHEU, 22.1 years) and Z-scores for measures of left ventricular (LV) systolic function and structure were calculated. Within-participant changes in Z-scores since their previous echocardiogram were computed. Adjusted linear regression models were used to compare PHIV and PHEU for each echocardiogram Z-score and for within-participant changes in Z-scores over time. Among PHIV, multivariable models were used to evaluate the association of HIV disease and antiretroviral treatment measures with current Z-scores and Z-score changes. RESULTS: At follow-up, no differences were observed between PHIV and PHEU for any left ventricular (LV) parameter. However, both cohorts had substantially lower LV ejection fraction Z-scores (means = -0.79) than on their prior echocardiogram. Significantly larger decreases over time were observed for PHIV versus PHEU for LV end-diastolic dimension and end-diastolic and end-systolic volume Z-scores. Among PHIV, lower nadir CD4% was associated with lower ejection fraction Z-score and with larger decreases in ejection fraction Z-scores over time. CONCLUSION: We observed no evidence of progression to greater LV hypertrophy over ~10 years, but the lower observed ejection fraction could indicate underlying cardiac dysfunction. Continued follow-up of young adults with PHIV and PHEU using current cardiac imaging techniques is warranted.
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Williams et al. (2026) conducted a cohort in Perinatal HIV infection or exposure (n=158). Perinatal HIV infection (PHIV) vs. Perinatally HIV-exposed but uninfected (PHEU) was evaluated on Z-scores and within-participant changes in Z-scores for measures of left ventricular (LV) systolic function and structure. Young adults with PHIV and PHEU showed no differences in LV parameters at follow-up, though both cohorts had lower LV ejection fraction Z-scores (mean -0.79) compared to prior echocardiograms.
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