A study by a Wayne State University and Children’s Hospital of Michigan, Detroit Medical Center research team is shedding new light on the troubling question of whether the drugs often given to HIV-positive pregnant women can cause significant long-term heart problems for the non-HIV-infected babies they carry. The study recently published in the journal AIDS shows that while the HIV medications have been successful in helping to prevent the transmission of the virus from mother to infant, they are associated with persistently impaired development of heart muscle and reduced heart performance in non-HIV-infected children whose mothers received the medicines years earlier.

“What our study indicates is that there is potentially a long-term price to be paid for protecting the children of HIV-infected mothers from the virus,” said Steven E. Lipshultz, M.D., pediatrician-in-chief at the Children’s Hospital of Michigan and chair of pediatrics for the Wayne State University School of Medicine. Dr. Lipshultz is a specialist in the study of long-term toxic cardiac effects among children affected by cancer and HIV drug therapies.

“These medicines have been very effective at reducing the rate of transmission of HIV from mother to child,” added Lipshultz, the lead author of the study, “but the findings we have just published show clearly that further investigation of their long-term impact on the heart health of the children involved is needed. “Thanks to the new anti-HIVmedications, the rate of transmission has been lowered from 26 per cent to less than one per cent during the past few decades, and that has been a miracle of life for the children involved. Still, we do not want to be protecting these children from one disease, only to give them another one.”

The study compared heart development and long-term heart functioning in 428 uninfected children of HIV-infected mothers to children who had not been exposed to HIV from 2007 to 2012. The results pointed to a significant association between lagging heart muscle development and impaired pumping ability in the children of the HIV-infected mothers who had received the medications. “These findings clearly indicate the need for further study,” said Lipshultz, while pointing to one of the study’s key conclusions: “Subclinical differences in left ventricular structure and function with specific in-utero antiviral exposures indicate the need for a longitudinal study to assess long-term cardiac risk and cardiac monitoring recommendations.”

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