Majonga, Edith D.Rehman, Andrea M.Mchugh, GraceMujuru, Hilda A.Nathoo, KusumOdland, Jon OyvindFerrand, Rashida A.Kaski, Juan Pablo2020-11-302020-11-302020-04Majonga, E.D., Rehman, A.M., Mchugh, G. et al. 2020, 'Incidence and progression of echocardiographic abnormalities in older children with human immunodeficiency virus and adolescents taking antiretroviral therapy: a prospective cohort study', Clinical Infectious Diseases, vol. 70, no. 7, pp. 1372-1378, https://doi.org/10.1093/cid/ciz373.1058-4838 (print)1537-6591 (online)10.1093/cid/ciz373http://hdl.handle.net/2263/77196BACKGROUND : A high prevalence of cardiac abnormalities has been reported in children with human immunodeficiency virus (HIV) taking antiretroviral therapy (ART) in sub-Saharan Africa. We investigated the incidence and progression of cardiac abnormalities among children taking ART in Zimbabwe. METHODS : A prospective cohort study was conducted at a pediatric HIV clinic from 2014 to 2017. Children with HIV aged between 6 and 16 years and taking ART ≥6 months were enrolled. Transthoracic echocardiography was performed at baseline and after 18 months. RESULTS : Of 197 participants recruited at baseline, 175 (89%; 48% female; median age 12 years, interquartile range 10–14 years) were followed up. The incidences of left and right heart abnormalities were 3.52 and 5.64 per 100 person-years, respectively. Stunting was associated with the development of any cardiac abnormality (adjusted odds ratio 2.59, 95% confidence interval 1.03–6.49; P = .043). Right ventricular (RV) dilatation persisted at follow-up in 92% of participants and left ventricular (LV) diastolic dysfunction in 88%. Cardiac abnormalities present at baseline reverted to normal over the follow-up period in 11 (6%). There was an overall increase in mean z scores for LV, left atrium (LA), RV, interventricular septum, and LV posterior wall diameters at 18 months (P < .001). CONCLUSIONS : Despite ART, children with HIV have a high incidence of cardiac abnormalities, with only a minority being transient. Mean z scores for LV, LA, RV, interventricular septum, and LV posterior wall diameters increased over a relatively short follow-up period, suggesting the potential for progression of cardiac abnormalities. Longer follow-up is required to understand the clinical implications of these abnormalities.en© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.Human immunodeficiency virus (HIV)Antiretroviral therapy (ART)Cardiac abnormalitiesChildrenEchocardiographyCongenital heart defectArticle