Structural echocardiographic abnormalities seen in HIV/AIDS patients are independent of cd4 count

Ogunmodede, James Ayodele; Kolo, P.M.; Katibi, Ibraheem; Salami, AK; Omotoso, Ayodele

doi:10.4103/1119-3077.208954

Cited by 12 publications

(27 citation statements)

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“…This indicates that this association depends on HIVrelated factors, rather than ART use. This is in accordance to previous studies in both highincome settings and SSA that found a higher LVM index in PLHIV compared to HIV-negative controls [9,38,39,44,45]. Both higher immune activation and increased atherosclerotic processes have been proposed as a possible cause of the increase in LVM in PLHIV, in addition to conventional risk factors like obesity and hypertension [44,46].…”

Section: Plos Onesupporting

confidence: 92%

“…Multiple studies, both in high-income countries and SSA, have reported higher rates of diastolic dysfunction in PLHIV compared to HIV-negative people [37][38][39], and this has been associated with HIV-related factors like nadir CD4 cell count [40]. Diastolic function, as evaluated with E/A ratio and LA volume, did not differ between the groups in our study following adjustment for age and sex.…”

Section: Plos Onesupporting

confidence: 39%

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Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa

et al. 2021

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Background Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiographic characteristics in an urban African population, comparing HIV-positive people (treated and not yet treated) with HIV-negative controls. Methods We conducted a cross-sectional study in Johannesburg, South Africa. We enrolled HIV-positive participants from three randomized controlled trials that had recruited participants from routine HIV testing programs. HIV-negative controls were recruited from the community. Data were collected on demographics, cardiovascular risk factors, medical history and electrocardiographic and echocardiographic characteristics. Results In total, 394 HIV-positive participants and 153 controls were enrolled. The mean age of HIV-positive participants was 40±9 years (controls: 35±10 years), and 34% were male (controls: 50%). Of HIV-positive participants 36% were overweight or obese (controls: 44%), 23% had hypertension (controls: 28%) and 12% were current smoker (controls: 37%). Median time since HIV diagnosis was 6.0 years (IQR 2.3–10.0) and median treatment duration was 4.0 years (IQR 0.0–8.0), 50% had undetectable viral load. The frequency of anatomical cardiac abnormalities was low and did not differ between people with and without HIV. We observed no relation between HIV or anti-retroviral therapy (ART) and systolic or diastolic heart function. There was an association between ART use and corrected QT interval: +11.8 ms compared to HIV-negative controls (p<0.01) and +18.9 ms compared to ART-naïve participants (p = 0.01). We also observed a higher left ventricular mass index in participants on ART (+7.8 g/m2, p<0.01), but this association disappeared after adjusting for CD4 cell count, viral load and HIV-duration. Conclusion The low number of major cardiac abnormalities in this relatively young, well managed urban African HIV-positive population is reassuring. The increase in corrected QT interval and left ventricular mass may contribute to higher cardiac mortality and morbidity in people living with HIV in the long term.

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Section: Plos Onesupporting

confidence: 92%

Section: Plos Onesupporting

confidence: 39%

Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa

et al. 2021

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“…Studies from Congo and Cameroon showed prevalence of effusion of 20.4% and 46.5% respectively, showing very high prevalence in Africa (31,32). Others reported prevalence of as low as 4% to 16.6% (7,8,10,21,27,30,33,34) and in one study only two patients had pericardial effusion (35). There is a difference of the participants of the studies with some including patients with profound immunosuppression.…”

Section: Discussionmentioning

confidence: 92%

“…Neoformans and Herpes Simplex (30). Malignancies such as Lymphoma and Kaposi Sarcoma which have become less common with the widespread use of ART are other potential causes (5,30).…”

Section: Discussionmentioning

confidence: 99%

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

Woldeyes

Mulatu

Ephrem

et al. 2021

Preprint

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Background: Non-communicable diseases including cardiovascular diseases are becoming an important part of Human Immunodeficiency Virus (HIV) care. Echocardiography is a useful non-invasive tool to assess for cardiac disease and different echocardiographic abnormalities have been seen previously. Available evidence on the echocardiographic abnormalities in Ethiopia is scarce. The aim of this study was to investigate the echocardiographic abnormalities in HIV infected patients and factors associated with the findings.Methods: A cross-sectional study was conducted on 285 patients with HIV infection including collection of clinical and echocardiographic data. Logistic regression was used to examine the association between echocardiographic abnormalities and associated factors with variables with a p-value of < 0.05 in the multivariate model considered statistically significant.Results: Diastolic dysfunction was the most common abnormality seen in 30.1% of the participants followed by regional wall motion abnormality (22.2%), left ventricular hypertrophy (10.3%), enlarged left atrium (8.1%), pulmonary hypertension (3.5%) and pericardial effusion (2.1%). Almost all patients had normal left ventricle systolic function. Diastolic dysfunction was independently associated with increasing age, elevated blood pressure and left ventricular hypertrophy while regional wall motion abnormality was associated with male gender, increasing age and abnormal fasting blood glucose. Left ventricular hypertrophy was associated with increasing age and blood pressure and the later was associated with left atrial enlargement. The level of immunosuppression did not affect echocardiography findings. Conclusions: A high prevalence of echocardiographic abnormalities was found and included diastolic dysfunction, regional wall motion abnormality, left ventricular hypertrophy and left atrial enlargement. Male gender, age above 50 years, elevated blood pressure and elevated fasting blood glucose were associated with echocardiographic abnormalities. Appropriate screening and treatment of echocardiographic abnormalities is needed.

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

et al. 2022

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Noncommunicable diseases including cardiovascular diseases are becoming an important part of human immunodeficiency virus (HIV) care. Echocardiography is a useful noninvasive tool to assess cardiac disease and different echocardiographic abnormalities have been seen previously. The aim of this study was to investigate the echocardiographic abnormalities in HIV-infected patients and factors associated with the findings.A cross-sectional study was conducted on 285 patients with HIV infection including collection of clinical and echocardiographic data. Logistic regression was used to examine the association between echocardiographic abnormalities and associated factors with variables with a P value of <.05 in the multivariate model considered statistically significant.Diastolic dysfunction was the most common abnormality seen in 30% of the participants followed by ischemic heart disease (19.3%), left ventricular hypertrophy (10.2%), enlarged left atrium (8.1%), pulmonary hypertension (3.6%), and pericardial effusion (2.1%). Diastolic dysfunction was independently associated with increasing age, elevated blood pressure, and left ventricular hypertrophy while ischemic heart disease was associated with male gender, increasing age, and abnormal fasting blood glucose. Left ventricular hypertrophy was associated with increasing age and blood pressure and the later was associated with left atrial enlargement. The level of immunosuppression did not affect echocardiography findings.A high prevalence of echocardiographic abnormalities was found. Male gender, age >50 years, elevated blood pressure, and elevated fasting blood glucose were associated with echocardiographic abnormalities. Appropriate follow-up and treatment of echocardiographic abnormalities is needed.

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Structural echocardiographic abnormalities seen in HIV/AIDS patients are independent of cd4 count

Cited by 12 publications

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Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa

Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa

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

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

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