Table 1:

Summary of recent reports of cardiovascular complication in pediatric HIV

Author and Year	Country	Population	Age Range (years)	Design	Parameters used	Findings
CONDUCTION AND FUNCTIONAL ABNORMALITIES
Namuyonga et al, 2016[13]	Uganda	285 PHIV children	1-18	Cross Sectional	• EKG • TT Echocardiogram	• Cardiac abnormalities detected in 14% children • Most common abnormalities: T-wave changes, pericardial disease
Lipshultz et al, 2017[11]	USA	74 HIV+ on ART compared to 140 HIV+ not on ART (conducted from 1990-1997)	3-16	Longitudinal	Serial TT Echocardiograms	• ART + children had more normal LV function and structure than pre-ART children • Cardiac function in ART+ children declined with increased follow up
Wilkinson et al, 2018[12]	USA	Adolescent Master Protocol (AMP) study in the Pediatric HIV/AIDS Cohort Study (PHACS) 246 PHIV Youth 156 HEU	7-16	Cross Sectional	• TT Echocardiogram • Serum TNT	• PHIV had higher biomarker levels associated with lower LV mass and structure
Majonga et al, 2018[14]	Zimbabwe	201 PHIV	6-16	Cross Sectional	TT Echocardiogram	• Abnormalities detected in 42% children • Most common abnormalities: LV diastolic dysfunction, LVH
Majonga et al, 2020[15]	Zimbabwe	197 PHIV	6-16	Longitudinal	TT Echocardiogram at baseline and 18 months later	• RV dilatation persisted at follow up in 92% of participants and LV dysfunction in 88% • 6% of Cardiac abnormalities present at baseline reverted to normal • Overall increase in mean z scores for LV, LA, RV and LV diameters
McCrary et al, 2020[16]	Kenya	643 PHIV	0-26	Cross sectional	TT Echocardiogram Myocardial Performance Index	• PHIV with cardiac dysfunction were older, viremic with exposure to AZT and higher systemic inflammation • MPI was associated with serum inflammatory marker IL6.
VASCULAR DISEASE
Abd-Elmoniem et al, 2014[33]	USA	35 HIV+ and 11 healthy controls	15-29	Cross Sectional	RCA vessel wall thickness measured by MRI	• Increase in vessel wall thickness in HIV+ • Epicardial fat not increased in HIV+ • Smoking and exposure to D4T associated with vessel thickness
Gleason et al, 2016[29]	Ethiopia	231 PHIV	6-17	Cross sectional	PWV , IMT and FMD	• Children on EFV and LPV/r has increased PWV and IMT compared to those on NVP
Hanna et al, 2016[30]	USA	5 cohorts from NHLBI HIV-CVD Collaborative 58 HIV+ and 221 HIV− controls in pediatric study	6-29	Cross sectional	IMT	• Higher IMT in HIV+ than HIV− in 6-29 age group • Increase in IMT in HIV+ compared to HIV-was strengthened when limited to PHIV
Eckard et al, 2017[28]	USA	101 HIV and 86 healthy controls	8-25	Cross sectional	PWV and IMT	• No difference in PWV between the groups
Dirajlal-Fargo et al, 2020[31]	Uganda	101 PHIV and 96 HIV−	10-18	Cross sectional	IMT and PWV	• Higher IMT in PHIV • IMT independently associated with marker of intestinal permeability in PHIV
Majonga et al, 2020[32]	Zimbabwe	117 PHIV and 75 HIV−	6-16	Cross sectional	IMT	• No difference in IMT between groups
ENDOTHELIAL DYSFUNCTION
Dirajlal-Fargo et al, 2017[39]	USA	71 HIV+ and 48 HIV-controls	8-30	Cross Sectional	EndoPAT	• Endothelial dysfunction in PHIV compared to behaviorally infected group and control group
Mahtab et al, 2020[38]	South Africa	431 PHIV and 93 HIV− youth			EndoPAT	• PHIV had higher rates of endothelial dysfunction • PI use associated with endothelial dysfunction

Abbreviations: D4t: stavudine; EFV: efavirenz, FMD: Flow mediated dilation; HEU: HIV-exposed uninfected; IMT: intima media thickness; LA: left atrium; LPV/r: ritonavir boosted lopinavir; LV: left ventricle; LVH: left ventricular hypertrophy; MRI: magnetic resonance imaging; MPI: myocardial performance index; NVP: nevirapine; PHIV: perinatally acquired HIV; PI: protease inhibitors; PWV: pulse wave velocity; RA: right atrium; RCA: right coronary artery; RV: right ventricle; TT : transthoracic