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We evaluated a group of persons newly diagnosed with HIV and studied the evolution of cardiac abnormalities after ART initiation. We recruited a group of newly diagnosed, ART na\u00efve persons with HIV and a healthy, HIV uninfected group. Participants underwent comprehensive cardiovascular evaluation, including cardiovascular magnetic resonance imaging. The HIV group was started on ART and re-evaluated 9\u00a0months later. The cardiovascular parameters of the study groups were compared at diagnosis and after 9\u00a0months. The ART na\u00efve group\u2019s (n\u2009=\u200966) left- and right end diastolic volume indexed for height were larger compared with controls (n\u2009=\u200922) (p\u2009&lt;\u20090.03). The left ventricular mass indexed for height was larger in the na\u00efve group compared with controls (p\u2009=\u20090.04). The ART na\u00efve group had decreased left- and right ventricular ejection fraction (p\u2009&lt;\u20090.03) and negative, non-linear associations with high HIV viral load (p\u2009=\u20090.02). The left ventricular size increased after 9\u00a0months (p\u2009=\u20090.04), while the systolic function remained unchanged. The HIV group had a high rate of non-resolving pericardial effusions. HIV infected persons demonstrate structurally and functionally altered ventricles at diagnosis. High HIV viral load was associated with left- and right ventricular dysfunction. Cardiac parameters and pericardial effusion prevalence did not show improvement with ART. Conversely, a concerning trend of increase was observed with left ventricular size. These subclinical cardiac abnormalities may represent a stage on the continuum of HIVAC that can progress to symptomatic disease if the causes are not identified and addressed.\n<\/jats:p>","DOI":"10.1007\/s10554-022-02711-y","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T10:02:47Z","timestamp":1661508167000},"page":"169-182","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Altered cardiac structure and function in newly diagnosed people living with HIV: a prospective cardiovascular magnetic resonance study after the initiation of antiretroviral treatment"],"prefix":"10.1007","volume":"39","author":[{"given":"Pieter-Paul S.","family":"Robbertse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton F.","family":"Doubell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Steyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl J.","family":"Lombard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Talle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip G.","family":"Herbst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"2711_CR1","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1056\/NEJM198609043151007","volume":"315","author":"IS Cohen","year":"1986","unstructured":"Cohen IS, Anderson DW, Virmani R, Reen BM, Macher AM, Sennesh J, DiLorenzo P, Redfield RR (1986) Congestive cardiomyopathy in association with the acquired immunodeficiency syndrome. 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