Cardiovascular Abnormalities in Patients With Hiv Infection: A Bolt in Blue

Abstract

One of the consistent findings among various studies on HIV has been simultaneous multiorgan dysfunction. Cardiovascular disorders are now most common cause of mortality worldwide. With more effective and widespread treatment of HIV in resourcerich settings, morbidity and mortality from non-AIDS-related events have surpassed those from AIDS-related events with cardiovascular diseases emerging as an important cause of death in HIV-infected patients relative to the decreasing incidence of opportunistic disease. Various studies have reported a 1.5-fold increase in the rate of cardiovascular events in HIV-infected individuals compared to control populations. MATERIAL AND METHODSThe aim of the study was to the find the prevalence and types of different cardiovascular abnormalities in HIV positive patients and assess their association with CD4 counts. Consecutive 82 patients, HIV positive patients fulfilling the inclusion criteria and giving informed consent were included in the study. All patients were subjected to history taking and a detailed physical examination. Blood counts, renal function tests, lipid profile and CD4 counts were estimated and patients were subjected to 12-lead ECG, chest X-ray and 2D/Colour Doppler Echocardiogram. RESULTSOf the 82 patients studied 47.46% had evidence of cardiovascular involvement, out of which 12% had clinical features of heart failure while electrocardiographic changes were seen in 35% of patients in the form of sinus tachycardia (27%), QTc prolongation (10%) and left sided chamber enlargements (6%). Echocardiographic abnormalities were noted in 39 patients (47.56%) including fractional shortening associated with systolic dysfunction (26.8%). The mean CD4 count in patients with echocardiographic abnormalities was found to be 58.87±29.80, whereas in patients without echocardiographic abnormalities it was 136.53±38.80 (p<0.0001). CONCLUSIONHigh frequencies of cardiac abnormalities, both symptomatic and asymptomatic were detected in the HIV/AIDS patients in our study. Furthermore, the study concluded that a careful initial and periodic cardiac evaluation to detect early involvement of the cardiovascular system in the HIV disease is recommended. Since the HIV-infected population is relatively young and actual cardiovascular events are infrequent, more long terms studies are needed.