Cardiovascular Manifestations of Hiv Infected Patients: Results of a Single Centre Study From a Tertiary Care Centre

Abstract

BACKGROUND To study cardiac diseases in Human Immunodeficiency (HIV) infected patients and examine correlations of cardiovascular manifestations with CD4 counts and Anti-Retroviral Therapy (ART). MATERIALS AND METHODS In this cross-sectional study, HIV seropositive patients admitted in medicine ward were evaluated for presence of cardiac diseases by clinical examination and non-invasive cardiovascular investigation (chest x-ray, ECG and ECHO). RESULTS Fifty patients (mean age 37.36 years) were included. A total of 64% had Acquired Immune Deficiency Syndrome (AIDS), while 46% were on ART. Cardiac disorders were detected in 52% patients; however, only 6% patients were symptomatic. Systolic dysfunction, diastolic dysfunction, pericardial effusion, dilated cardiomyopathy, pulmonary hypertension and cardiac tumour were detected in 5 (10%), 16 (32%), 6 (12%), 3 (6%), 4 (8%) and 1 (2%) patients respectively. In 39 (78%) patients Electrocardiogram (ECG) was normal, whereas 11 (22%) patients showed abnormalities in the ECG. The abnormalities included sinus tachycardia 7 (14%), Ischaemic Heart Disease (IHD) 2 (4%), Left Ventricular Hypertrophy (LVH) 1 (2%) and low voltage complexes 1 (2%). Cardiomegaly was detected in 3 (6%) patients. Lower CD4 count was not associated with cardiac disorders (x 2 = 12; p = 0.213), but was associated with pericardial effusion (x 2 = 28 and p = 0.032). Lower CD4 count was significantly associated with cardiomyopathy (table 3; x 2 = 54; p = 0.000), but not with diastolic dysfunction (x 2 = 50; p = 0.394). ART status was not associated with cardiomyopathy (x 2 = 6; p = 0.199) or diastolic dysfunction (x 2 = 0.995; p = 0.318). CONCLUSION Cardiac disorders are common in HIV infected patients, but only few are symptomatic. Non-invasive investigations help in early diagnosis of asymptomatic cardiac disorders.