Pediatric and Developmental Pathology

, Volume 7, Issue 1, pp 61–70

Cardiac, Aortic, and Pulmonary Arteriopathy in HIV-infected children: The Prospective P2C2 HIV Multicenter Study

  • A.R. Perez-Atayde
  • D.I. Kearney
  • J.T. Bricker
  • S.D. Colan
  • K.A. Easley
  • S. Kaplan
  • W.W. Lai
  • S.E. Lipshultz
  • D.S. Moodie
  • G. Sopko
  • T.J. Starc
  • for the P2C2 HIV Study Group
Original Article

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.

arteriosclerosis cardiomyopathy vasa vasorum 

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Copyright information

© Society for Pediatric Pathology 2004

Authors and Affiliations

  • A.R. Perez-Atayde
    • 1
  • D.I. Kearney
    • 2
  • J.T. Bricker
    • 2
  • S.D. Colan
    • 1
  • K.A. Easley
    • 3
  • S. Kaplan
    • 4
  • W.W. Lai
    • 5
  • S.E. Lipshultz
    • 1
  • D.S. Moodie
    • 3
  • G. Sopko
    • 6
  • T.J. Starc
    • 7
  • for the P2C2 HIV Study Group
  1. 1.Departments of Pathology and CardiologyChildren’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Departments of Pathology and CardiologyTexas Children’s Hospital, Baylor College of MedicineHoustonUSA
  3. 3.Departments of Biostatistics and Epidemiology, and Division of Pediatric and Adolescent MedicineThe Cleveland Clinic FoundationClevelandUSA
  4. 4.Department of Pediatrics, Division of Pediatric CardiologyUniversity of California, Los Angeles Medical Center and School of MedicineLos AngelesUSA
  5. 5.Department of Pediatrics, Division of Pediatric CardiologyMt. Sinai School of MedicineNew YorkUSA
  6. 6.National Heart, Lung and Blood InstituteBethesdaUSA
  7. 7.Department of Pediatrics, Division of Pediatric CardiologyPresbyterian Hospital/Columbia University College of Physicians and SurgeonsNew YorkUSA

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