Cardiomyopathy Associated with Antiretroviral Therapy in Patients with HIV Infection: A Report of Six Cases

Brief Reports15 February 1992Cardiomyopathy Associated with Antiretroviral Therapy in Patients with HIV Infection: A Report of Six CasesAhvie Herskowitz, MD, Sharon B. Willoughby, MA, Kenneth L. Baughman, MD, Steven P. Schulman, MD, John D. Bartlett, MDAhvie Herskowitz, MD, Sharon B. Willoughby, MA, Kenneth L. Baughman, MD, Steven P. Schulman, MD, John D. Bartlett, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-4-311 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSymptomatic congestive heart failure has been described as part of the spectrum of human immunodeficiency virus (HlV)-related cardiac disease (1-3). Echocardiographic studies have further documented dilated cardiomyopathy in 11% to 22% of HIV-infected adults (4, 5).The direct etiologic role of HIV infection in cardiomyopathy is controversial. In-situ hybridization studies have failed to show HIV genomic material in endomyocardial biopsy samples taken from patients with HIV-associated myocarditis and clinically established congestive heart failure (6). Rare infected myocytes have, however, been shown using similar techniques in autopsy specimens from patients without heart disease (7). Other etiologies should be considered, such as...References1. Cohen I, Anderson D, Virmani R, Reen B, Macher A, and Sennesh J. Congestive cardiomyopathy in association with the acquired immunodeficiency syndrome. N Engl J Med. 1986;315:628-30. CrossrefMedlineGoogle Scholar2. Reilly J, Cunnion R, Anderson D, O'Leary T, Simmons J, and Lane H. Frequency of myocarditis, left ventricular dysfunction and ventricular tachycardia in the acquired immune deficiency syndrome. Am J Cardiol. 1988;66:789-93. CrossrefGoogle Scholar3. Baroldi G, Corallo S, Moroni M, Repossini A, Mutinelli M, and Lazzarin A. Focal lymphocytic myocarditis in acquired immunodeficiency syndrome (AIDS): a correlative morphologic and clinical study in 26 consecutive fatal cases. J Am Coll Cardiol. 1988;12:463-9. CrossrefMedlineGoogle Scholar4. Corallo S, Mutinelli M, Moroni M, Lazzarin A, Celano V, and Repossini A. Echocardiography detects myocardial damage in AIDS: A prospective study in 102 patients. Eur Heart J. 1988;9:887-92. CrossrefMedlineGoogle Scholar5. Anderson D and Virmani R. Emerging patterns of heart disease in human immunodeficiency virus infection. Hum Pathol. 1990;21:253-9. CrossrefMedlineGoogle Scholar6. Beschorner W, Baughman K, Turnicky R, Hutchins G, Rowe S, and Kavanaugh-McHugh A. HIV-associated myocarditis. Pathology and immunopathology. Am J Pathol. 1990;137:1365-71. MedlineGoogle Scholar7. Grody W, Cheng L, and Lewis W. Infection of the heart by the human immunodeficiency virus. Am J Cardiol. 1990;66:203-6. CrossrefMedlineGoogle Scholar8. Lewis W, Papoian T, Gonzales B, Louie H, Kelly D, and Payne R. Mitochondrial ultrastructural and molecular changes induced by zidovudine in rat hearts. Lab Invest. 1991;65:228-36. MedlineGoogle Scholar9. Dalakas M, Illa I, Pezeshkpour G, Laukaitis J, Cohen B, and Griffin J. Mitochondrial myopathy caused by long-term zidovudine therapy. N Engl J Med. 1990;322:1098-105. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Ahvie Herskowitz, MD; Sharon B. Willoughby, MA; Kenneth L. Baughman, MD; Steven P. Schulman, MD; John D. Bartlett, MDFrom The Johns Hopkins Hospital and School of Public Health and Hygiene, Baltimore, Maryland. For current author addresses, see end of text. 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