Document 1155
 DOCN  M94A1155
 TI    Non-invasive methods for the precocious diagnosis of cardiac
       abnormalities in HIV infected children.
 DT    9412
 AU    Yu CL; Catani LH; Della Negra M; Queiroz W; Paste AA; Soraggi Neto C;
       Silva LM; Inst. Infectol. Emilio Ribas, FCMSCSP.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):196 (abstract no. PB0799). Unique
       Identifier : AIDSLINE ICA10/94371420
 AB    OBJECTIVE: To establish the percentage of clinically inapparent cardiac
       abnormalities among HIV infected children trying to define the best way
       for a precocious diagnosis and its correlation with CD4 count and
       Pediatric AIDS classification according to the CDC criteria. METHODS:
       Forty one children (10 P-1 and 31 P-2) without cardiac symptoms were
       evaluated using electrocardiography (ECG), 2-dimensional and doppler
       echocardiography (ECO), chest X-ray and had blood samples collected for
       albumin, blood cells and CD4+ lymphocytes count. Age varied from 19 to
       .105 months. RESULTS: ECG was abnormal in 22 children (53,6%) and ST-T
       waves changes were observed in 9 patients (21,9%) and left ventricular
       enlargement in 5 (12,2%). ECO was abnormal in 10 patients (24,4%) and
       hyper-dynamic left ventricular performance was the most common finding.
       X-ray showed cardiomegaly in 3 children in which the ECO revealed left
       ventricular inlargement in 2 cases and pericardial effusion in 1. Anemia
       and hipoalbuminemia were found in 8 and 2 children, without statistical
       correlation with any of the cardiac abnormalities. Eight children
       (21,6%) had CD4 count below 20% of the normal value. All of them showed
       at least one abnormality at the cardiac studies. There was no
       correlation between cardiac findings and Pediatric AIDS classification.
       DISCUSSION: ECG seems to be the most sensitive study to predict
       clinically inapparent cardiac abnormalities among HIV-infected children.
       With this preliminar study we may infer that ECG and ECO abnormalities
       precede symptomatic cardiopathies. There were no correlations between
       the cardiac findings and the other parameters studied. Despite all the
       children with CD4 below 20% of the normal value had cardiac
       abnormalities, they appear in children with high levels of CD4. Cardiac
       abnormalities, detectable by ECG and ECO but clinically inapparent seem
       to be common among HIV infected children. Cardiac assesment should
       become part of the routine follow up of this population favouring a
       precocious diagnosis, a guided management and therapeutic intervention,
       when possible.
 DE    Child  Child, Preschool  Echocardiography, Doppler  Electrocardiography
       Heart Diseases/*COMPLICATIONS/DIAGNOSIS  Human  HIV
       Infections/*COMPLICATIONS/IMMUNOLOGY  Infant  Leukocyte Count  T4
       Lymphocytes  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).