Congenital cardiovascular malformations in children of HIV-infected mothers

Abstract

The effects of maternal HIV infection and mother-infant HIV transmission on the prevalence and distribution of congenital cardiovascular malformations in the children of HIV-infected mothers are reviewed. Only two studies have prospectively examined the prevalence of congenital cardiovascular malformations in children of HIV-infected mothers. The Italian Multicenter Study demonstrated a trend toward a higher prevalence of congenital cardiovascular malformations in HIV-infected children as compared to general population-based data, but the number of cases identified was small ( 4 165 , 2.4%). The National Heart, Lung, and Blood Institute P 2C 2 HIV Study, using routine screening echocardiograms as the method of case identification, preliminary reported a congenital cardiovascular malformation prevalence of 12.3% ( 68 555 ) in children of HIV-infected mothers. The prevalence and distribution of congenital cardiovascular malformations were not significantly different from populations of normal infants similarly screened in other studies. Mother-infant HIV transmission did not appear to significantly affect congenital cardiovascular malformation prevalence. Certain issues regarding the treatment for children of HIV-infected women remain undecided. With the information currently available, decisions regarding cardiac surgery for HIV-infected children should be based on standard clinical parameters and indications. The exposure of a neonate to maternal HIV infection should not delay or significantly alter the management of a life-threatening congenital cardiovascular malformation.