Abstract
Abstract Background Few data exist on myocardial fibrosis and inflammation in youth with HIV. Methods We performed cardiovascular magnetic resonance (CMR) on a cross-section of South African youth: youth with perinatally acquired HIV (YPHIV) on antiretroviral therapy (ART), with non-perinatally acquired HIV (YNPHIV) on ART, and without HIV. Quantile regression models were fit to assess the association between HIV status and CMR outcomes: subclinical fibrosis [late gadolinium enhancement (LGE) mass and fraction, native T1, extracellular volume] and inflammation (native T1, T2 mapping). Results Of 464 youth, 287 were YPHIV, 87 YNPHIV, and 90 HIV-seronegative youth. Median age was 16 years (range 11-24). LGE mass (1.85 vs. 2.00 vs. 1.41g, respectively) and fraction (5.8 vs. 6.4 vs. 4.5%, respectively) were higher in YPHIV and YNPHIV than HIV-seronegative youth; native T1 was highest in YNPHIV. In adjusted analyses, compared to HIV-seronegative youth, YPHIV and YNPHIV exhibited higher LGE mass (β:0.468, p=0.001 and β:0.544, p=0.002, respectively) and LGE fraction (β:1.587, p<0.001, β:1.781, p<0.001). CMR outcomes were similar between YPHIV and YNPHIV. Conclusion Despite ART use, YPHIV and YNPHIV appear to have higher subclinical myocardial fibrosis than HIV-seronegative youth and healthy adults in South Africa and may benefit from early screening/monitoring for cardiovascular disease.
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