New study finds anti-HIV treatment may protect children’s hearts

Children who now receive antiretroviral therapy have been shown to have about 40 percent less heart damage than children who received single drug or no treatment in the 1990s.

The combination drug therapy now used to treat children born with HIV-1 appears to protect against previously common heart damage, according to a new study published earlier this week.

The study, funded by the National Institutes of Health (NIH), found that fewer HIV-positive children on today’s combination drug treatment had heart damage than those who participated in a study in the 1990s. 

A common modern treatment for children born with HIV-1 is a combination of three or more anti-HIV drugs in an approach called highly active antiretroviral therapy, or HAART. In the 1990s, children exposed to the virus either did not receive anti-HIV therapy or were only treated with one drug. 

Before HAART was widely available, chronic heart conditions among children living with HIV were common. In fact, NIH reported that heart failure was the underlying cause of death for 25 percent of HIV-infected children who died after the age of 10 before the widespread use of combination antiretroviral drug treatment. 

The newly released study examined the structure and functioning of the hearts of 500 children between the ages of 7 and 16 receiving HAART. This was accomplished using a technique called echocardiography, which generates images of the heart using sound waves.

Researchers then compared the results to a National Heart, Lung and Blood Institute (NHLBI) study conducted in the 1990s and found that overall, children in the HAART group fared better than their counterparts in the 1990s. About 45 percent of the children in the 1990s study had an enlarged heart or substantial damage to the heart muscle, while only four percent in the HAART group had such damage.

“One of the miracles of modern medicine related to HIV is coming up with medicines that can’t eliminate HIV but they dramatically reduce it,” first author Dr. Steven E. Lipshultz, of the University of Miami Miller School of Medicine, told Bloomberg. “In addition to dramatically reducing it, it seems to help have a more healthy heart because there’s less virus and an overall normal immune system in these healthy children.”

The research appeared in JAMA Pediatrics and was part of the Pediatric HIV/AIDS Cohort Study (PHACS).