Bowles N E, Kearney D L, Ni J, Perez-Atayde A R, Kline M W, Bricker J T, Ayres N A, Lipshultz S E, Shearer W T, Towbin J A
Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA.
J Am Coll Cardiol. 1999 Sep;34(3):857-65. doi: 10.1016/s0735-1097(99)00264-8.
The aim of this study was to investigate the frequency of viral nucleic acid detection in the myocardium of human immunodeficiency virus (HIV)-infected children to determine whether an association exists with the development of heart disease.
As improved medical interventions increase the life expectancy of HIV-infected patients, increased incidences of myocarditis and dilated cardiomyopathy (DCM) are becoming more apparent, even in patients without clinical symptoms.
Myocardial samples were obtained from the postmortem hearts of 32 HIV-infected children and from 32 age-matched controls consisting of patients with structural congenital heart disease and no myocardial inflammation and no cardiac or systemic viral infection. The hearts were examined histologically and analyzed for the presence of viral sequences by polymerase chain reaction (PCR) or reverse transcription-PCR.
Myocarditis was detected histologically in 11 of the 32 HIV-infected patients, and borderline myocarditis was diagnosed in another 13 cases. Infiltrates were confined to the epicardium in two additional hearts. Virus sequences were detected by PCR in 11 of these 26 cases (42.3%); adenovirus in 6, CMV in 3 and both adenovirus and CMV in 2. Two cases without infiltrates were also positive for adenovirus: one had congestive heart failure (CHF) and the other adenoviral pneumonia. No other viruses were detected by PCR, including HIV proviral DNA. All control samples were negative for all viruses tested.
These data suggest that the presence of viral nucleic acid in the myocardium is common in HIV-infected children, and may relate to the development of myocarditis, DCM or CHF and may contribute to the rapid progression of HIV disease.
本研究旨在调查人类免疫缺陷病毒（HIV）感染儿童心肌中病毒核酸检测的频率，以确定其与心脏病发展之间是否存在关联。
随着医疗干预措施的改进延长了HIV感染患者的预期寿命，心肌炎和扩张型心肌病（DCM）的发病率增加，这一现象日益明显，即便在无临床症状的患者中也是如此。
从32例HIV感染儿童的尸检心脏以及32例年龄匹配的对照者的心脏获取心肌样本，对照者包括患有结构性先天性心脏病、无心肌炎症且无心脏或全身性病毒感染的患者。对心脏进行组织学检查，并通过聚合酶链反应（PCR）或逆转录PCR分析病毒序列的存在情况。
在32例HIV感染患者中，有11例经组织学检测发现心肌炎，另有13例被诊断为临界性心肌炎。另有两颗心脏的浸润局限于心外膜。在这26例患者中，有11例（42.3%）通过PCR检测到病毒序列；其中6例为腺病毒，3例为巨细胞病毒（CMV），2例同时存在腺病毒和CMV。另外两例无浸润的患者腺病毒检测也呈阳性：一例患有充血性心力衰竭（CHF），另一例患有腺病毒性肺炎。通过PCR未检测到其他病毒，包括HIV前病毒DNA。所有对照样本检测的所有病毒均为阴性。
这些数据表明，HIV感染儿童心肌中病毒核酸的存在很常见，可能与心肌炎、DCM或CHF的发展有关，并可能促使HIV疾病快速进展。
Zotero 插件