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

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Pediatric and Developmental Pathology

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.

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ACKNOWLEDGMENTS

This work was supported by the National Heart, Lung, and Blood Institute (NO1-HR-96037, NO1-Hr-96038, NO1-Hr-96039, NO1-Hr-96040, NO1-Hr-96041, NO1-Hr-96042, and NO1-Hr-96043) and in part by the National Institutes of Health General Clinical Research Center Grants (RR-00188, RR-00533, RR-00071, RR-00645, RR-00865, and RR-00043).

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Authors and Affiliations

  1. Departments of Pathology and Cardiology, Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA

    A.R. Perez-Atayde, S.D. Colan & S.E. Lipshultz

  2. Departments of Pathology and Cardiology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA

    D.I. Kearney & J.T. Bricker

  3. Departments of Biostatistics and Epidemiology, and Division of Pediatric and Adolescent Medicine, The Cleveland Clinic Foundation, Cleveland, OH, USA

    K.A. Easley & D.S. Moodie

  4. Department of Pediatrics, Division of Pediatric Cardiology, University of California, Los Angeles Medical Center and School of Medicine, Los Angeles, CA, USA

    S. Kaplan

  5. Department of Pediatrics, Division of Pediatric Cardiology, Mt. Sinai School of Medicine, New York, NY, USA

    W.W. Lai

  6. National Heart, Lung and Blood Institute, Bethesda, MD, USA

    G. Sopko

  7. Department of Pediatrics, Division of Pediatric Cardiology, Presbyterian Hospital/Columbia University College of Physicians and Surgeons, New York, NY, USA

    T.J. Starc

Authors
  1. A.R. Perez-Atayde
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  2. D.I. Kearney
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  3. J.T. Bricker
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  4. S.D. Colan
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  5. K.A. Easley
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  6. S. Kaplan
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  7. W.W. Lai
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  8. S.E. Lipshultz
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  9. D.S. Moodie
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  10. G. Sopko
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  11. T.J. Starc
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for the P2C2 HIV Study Group

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Correspondence to A.R. Perez-Atayde.

Additional information

Authors Antonio R. Perez-Atayde and Debra L. Kearney contributed equally to this article.

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Perez-Atayde, A., Kearney, D., Bricker, J. et al. Cardiac, Aortic, and Pulmonary Arteriopathy in HIV-infected children: The Prospective P2C2 HIV Multicenter Study. Pediatr. Dev. Pathol. 7, 61–70 (2004). https://doi.org/10.1007/s10024-003-1001-9

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  • DOI: https://doi.org/10.1007/s10024-003-1001-9

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