Cardiovascular abnormalities including cardiomyopathy have been reported in AIDS, but neither the frequency nor the etiology of cardiovascular abnormalities is well defined. This study will have two goals: the first is to identify in a prospective, randomly chosen, controlled, longitudinal study the incidence of abnormalities in HIV-positive male patients as detected by quantitative Doppler echocardiography. Group I - HIV seropositive, asymptomatic infection Group II- Hiv seropositive, persistent generalized lymphadenopathy (PGL) Group III- Aids patients Group IV- Age-matched, clinically-well, HIV seronegative, homosexual men (controls for Groups I and II) Group V- Control group of seronegative, age-matched, clinically """"""""ill patients"""""""" (controls for Group III) with chronic pneumonitis, carcinoma, or inflammatory bowel disease matched for similar states of inanition (% normal body weight lost). The patients will be clinically followed and have Doppler echocardiograms every four months for four years. The incidence of abnormalities found will be compared to the incidence found in the control group. The second goal is to identify the etiology of clinical or echocardiographic pericardial and myocardial abnormalities. Any patient from the echocardiographic portion of the study or patients from clinics or wards of SFGH or Moffitt-Long Hospitals or referred from other hospitals will be eligible. Myocardial or pericardial tissue obtained at the time of clinically-indicated biopsy or obtained at autopsy within 12 hours of death will be examined by light and electron microscopy, be cultured for fungi and viruses, and in the subgroup of patients with ventricular failure or myocarditis, with cultures for HIV, immunohistochemical procedures, and in situ hybridization techniques for the identification of HIV antigen in the myocardial or pericardial cells. These studies should give insight into the frequency with which Doppler-echo abnormalities will occur in follow-up over a four-year period in patients who are HIV seropositive compared to appropriate controls, as well as into the etiology of ventricular abnormalities in patients with AIDS.
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