Study title: Characterisation Of caRdiac Disease in adolescents with perinatally acquired HIV infection

Lead Researcher(s)

Edith Majonga

Funder(s)

 European and Developing Countries Clinical Trials Partnership

Partner(s)

Baines Imaging Group, Oxford Centre for Clinical Magnetic Resonance, University of Oxford

Background

The incidence of perinatal HIV has dropped dramatically from 280,000 in 2010 to 160,000 globally in 2018, due to scale-up of antiretroviral therapy (ART). Concurrently, increasing numbers of children with HIV are now surviving to adolescence. Long standing HIV in children is associated with an increased risk of cardiac disease despite effective ART, particularly but not exclusively in those who have had delayed HIV diagnosis and ART initiation. We have previously shown a high prevalence (42%) and incidence (8.8/100 person-years) of cardiac abnormalities using echocardiography in children with HIV aged 6-16 years taking ART. Cardiac magnetic resonance (CMR) is unique in identifying pathological tissue characteristics helping to understand underlying disease processes. Furthermore, pro-inflammatory, fibrotic and cardiac biomarkers enable assessment of cardiac remodeling and the extent of cardiac dysfunction.

Study aim(s)

To investigate cardiac function and structure using cardiac magnetic resonance (CMR) imaging and pathogenic mechanisms among adolescents with perinatally-acquired HIV (APH) taking ART.

Study design

CORD is a cross-sectional study which enrolled 120 adolescents with and without HIV (60 per group) aged 10-19 years. Clinical data including anthropometry, blood pressure, viral load, and detailed cardiac assessments were performed. Echocardiography and CMR imaging scans were performed as well as circulating biomarker of inflammation, cardiac damage and fibrosis assessment in all participants. Biomarkers were tested using bead multi-analyte assays (Luminex Technology) at the ZVITAMBO laboratory in Harare.

Study dates

June 2021-May 2024