Echocardiographic patterns in treatment-naïve HIV-positive patients in Lagos, south-west Nigeria : cardiovascular topic - online article

Olusegun-Joseph, D.A.; Ajuluchukwu, J N A; Okany, C C; Mbakwem, Amam; Oke, David Mautin; Okubadejo, Njideka

doi:10.5830/cvja-2012-048

Cited by 24 publications

(15 citation statements)

References 44 publications

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“…Both systolic and diastolic dysfunctions are more common (∼30% prevalence) in PLHIV than in controls without HIV (65), and rarely, diastolic dysfunction is more prevalent (42,60). Ventricular dimensions and mass are large in PLHIV with HF in SSA, similar to findings from North America (65,76). Up to one-third of African HIV-infected children have LVSD (63,64).…”

Section: Epidemiology Of Hiv-associated Hf In Lmics In the Art Eramentioning

confidence: 99%

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

Bloomfield

Alenezi

Barasa

et al. 2015

JACC: Heart Failure

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Successful combination therapy for human immunodeficiency virus (HIV) has transformed this disease from a short-lived infection with high mortality to a chronic disease associated with increasing life expectancy. This is true for high- as well as low- and middle-income countries. As a result of this increased life expectancy, people living with HIV are now at risk of developing other chronic diseases associated with aging. Heart failure has been common among people living with HIV in the eras of pre- and post- availability of antiretroviral therapy; however, our current understanding of the pathogenesis and approaches to management have not been systematically addressed. HIV may cause heart failure through direct (e.g., viral replication, mitochondrial dysfunction, cardiac autoimmunity, autonomic dysfunction) and indirect (e.g., opportunistic infections, antiretroviral therapy, alcohol abuse, micronutrient deficiency, tobacco use) pathways. In low- and middle-income countries, 2 large observational studies have recently reported clinical characteristics and outcomes in these patients. HIV-associated heart failure remains a common cardiac diagnosis in people living with heart failure, yet a unifying set of diagnostic criteria is lacking. Treatment patterns for heart failure fall short of society guidelines. Although there may be promise in cardiac glycosides for treating heart failure in people living with HIV, clinical studies are needed to validate in vitro findings. Owing to the burden of HIV in low- and middle-income countries and the concurrent rise of traditional cardiovascular risk factors, strategic and concerted efforts in this area are likely to impact the care of people living with HIV around the globe.

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Section: Epidemiology Of Hiv-associated Hf In Lmics In the Art Eramentioning

confidence: 99%

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

Bloomfield

Alenezi

Barasa

et al. 2015

JACC: Heart Failure

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“…Although ART has dramatically decreased the risk of opportunistic infections and mortality, there is mounting evidence that longstanding HIV infection and/or its treatment are associated with noninfectious complications, including cardiac disease [ 3 ]. Cardiac disease has been reported among treated and untreated HIV-infected adults, with prevalence ranging from 18 to 78% [ 4 , 5 ]. Low CD4 + cell count and high viral load have been identified as independent risk factors for cardiac disease, but residual confounding by well recognized traditional risk factors, such as smoking and hypertension remain an issue in these studies [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

High prevalence of echocardiographic abnormalities in older HIV-infected children taking antiretroviral therapy

Majonga

Rehman

Simms

et al. 2018

Aids

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Background:Antiretroviral therapy (ART) has decreased mortality so that increasing numbers of children with HIV are reaching adolescence. However, longstanding HIV infection and/or its treatment in children is associated with noninfectious complications including cardiac disease. We investigated the prevalence, spectrum and risk factors for echocardiographic abnormalities among children established on ART.Methods:HIV-infected children aged 6–16 years, on ART at least 6 months were enrolled into a cross-sectional study from a public-sector paediatric HIV clinic in Harare, Zimbabwe. A standardized examination including transthoracic echocardiography was performed. Local echocardiographic reference ranges were used to define cardiac abnormalities. Logistic regression was used to examine the association between cardiac abnormalities and risk factors.Results:Of the 201participants recruited, 92 (46%) were girls and median age was 11 (IQR 9–12) years; CD4+ cell count was 727 cells/μl (IQR 473–935) and 154 (78%) had viral load less than 400 copies/ml. Echocardiographic abnormalities were found in 83 (42%); left ventricular (LV) diastolic dysfunction was the most common abnormality 45 (23%) and LV hypertrophy in 22 (11%). LV and left atrial dilatation were found in 9 (5%) and 16 (8%), respectively. Right ventricular dilatation and systolic dysfunction were found in 13 (7%) and 4 (2%), respectively, of whom 60% had concurrent left heart abnormalities. Current use of nevirapine was associated with LVH [aOR 3.14 (1.13–8.72; P = 0.03)] and hypertension was associated with LV diastolic dysfunction [aOR 3.12 (1.48–6.57; P < 0.01)].Conclusion:HIV-infected children established on ART have a high burden of echocardiographic abnormalities. Right heart disease was predominantly associated with left heart abnormalities and may be part of a global cardiomyopathic process. Further studies are needed to investigate the natural history, aetiology, and pathogenesis of these abnormalities, so that appropriate monitoring and treatment strategies can be developed.

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“…A smaller survey from Lagos, Nigeria, investigated the prevalence of cardiovascular disease in an HIV-positive cohort and found 1 patient of 100 patients to have HIV-PAH. 13 An ECHO study on 102 HIV patients presenting with cardiac symptoms in Tanzania revealed PH in 13% 14. PH with an RVSP>30 mm Hg was present in 4% of long-term survivors in a Zimbabwe cohort of vertically acquired HIV infection 15.…”

Section: Introductionmentioning

confidence: 99%

Rationale and design of the Pan African Pulmonary hypertension Cohort (PAPUCO) study: implementing a contemporary registry on pulmonary hypertension in Africa

et al. 2014

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IntroductionPulmonary hypertension (PH) is a devastating, progressive disease with increasingly debilitating symptoms and usually shortened overall life expectancy due to a narrowing of the pulmonary vasculature and consecutive right heart failure. Little is known about PH in Africa, but limited reports suggest that PH is more prevalent in Africa compared with developed countries due to the high prevalence of risk factors in the region.Methods and analysisA multinational multicentre registry-type cohort study was established and tailored to resource-constraint settings to describe disease presentation, disease severity and aetiologies of PH, comorbidities, diagnostic and therapeutic management, and the natural course of PH in Africa. PH will be diagnosed by specialist cardiologists using echocardiography (right ventricular systolic pressure >35 mm Hg, absence of pulmonary stenosis and acute right heart failure), usually accompanied by shortness of breath, fatigue, peripheral oedema and other cardiovascular symptoms, ECG and chest X-ray changes in keeping with PH as per guidelines (European Society of Cardiology and European Respiratory Society (ESC/ERS) guidelines). Additional investigations such as a CT scan, a ventilation/perfusion scan or right heart catheterisation will be performed at the discretion of the treating physician. Functional tests include a 6 min walk test and the Karnofsky Performance Score. The WHO classification system for PH will be applied to describe the different aetiologies of PH. Several substudies have been implemented within the registry to investigate specific types of PH and their outcome at up to 24 months. Data will be analysed by an independent institution following a data analyse plan.Ethics and disseminationAll local ethics committees of the participating centres approved the protocol. The data will be disseminated through peer-reviewed journals at national and international conferences and public events at local care providers.

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Echocardiographic patterns in treatment-naïve HIV-positive patients in Lagos, south-west Nigeria : cardiovascular topic - online article

Cited by 24 publications

References 44 publications

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

High prevalence of echocardiographic abnormalities in older HIV-infected children taking antiretroviral therapy

Rationale and design of the Pan African Pulmonary hypertension Cohort (PAPUCO) study: implementing a contemporary registry on pulmonary hypertension in Africa

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