Echocardiographic Assessment of Asymptomatic US Air Force Members with Early HIV Infection

Abstract

Objective People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. In this study we describe the echocardiographic evaluations of asymptomatic US Air Force members who were diagnosed with HIV infection and evaluated at the San Antonio Military Medical Center between September 1, 2015 and September 30, 2016. Results Patients (n=50) were predominantly male (96%), mostly black (60%), with a mean age of 28 years. At HIV diagnosis, the mean viral load was 112,585 copies/mL and CD4 count was 551 cells/uL. All were found to have normal left ventricular systolic ejection fraction (EF) and global longitudinal strain (GLS) however evidence of right ventricular dilatation and left ventricular remodeling was observed in 7 (14%) and 13 (26%) patients, respectively. Subgroup analyses showed no significant differences in echocardiographic findings by HIV disease severity or CVD risk factors (p >0.05 for all).This study suggests that untreated HIV may have a low impact on the development of echocardiographic abnormalities shortly after seroconversion. Longitudinal studies are warranted to determine the optimal CVD risk assessment strategies for PLHIV.

Echocardiographic findings and associated factors in HIV-infected patients at a tertiary hospital in Ethiopia

“…[7,9,18,19] It has been reported in as low as 2% up to 85.7% of patients. [3,7,9,18–21] A recent systematic review reported pooled prevalence of 29.3%, a number similar to our study. [4] Similar to this study, increasing age has been shown to be an independent risk factor for DD in HIV patients [9] and is also a known risk factor in the general population.…”

“…[4] There are some studies where ≤4% of the studied population had low ejection fraction. [2,3,20] The sensitivity of echocardiography for pulmonary hypertension is not satisfactory. Invasive tests may be required in patients with strong clinical suspicion as it is associated with increased mortality.…”

Echocardiographic Findings and Associated Factors in HIV Infected Patients at a Tertiary Hospital in Ethiopia

“…High prevalence ranging from 42.8% in India to as high as in 85.7% in Congo have been reported in the past (3,7,9,18,19). The lowest report of diastolic dysfunction was from a study on patients with early HIV infection of only 2% (20). Other studies report prevalence from 9.25% to 19.9% (2, 21) with a recent systematic review reporting pooled prevalence of 29.3%, a number similar to our study (4).…”

“…A systematic review and meta-analysis published in 2018 showed the pooled prevalence of reduced ejection fraction below 50% was 12.3% which was more reduced in patients with AIDS showing the possible relation with immunode ciency and opportunistic infections and showed lower prevalence in patients on ART potentially explaining the preserved ejection fraction in our patients (4). There are some studies where four percent or less of the studied population had low ejection fraction (2,3,20).…”