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Pericardial involvement in human immunodeficiency virus infection
J Silva-Cardoso1, B Moura, L Martins
1Oporto Cardiovascular Research and Development Unit (JNICT 51/94), Porto Medical School, Hospital de S. João, Portugal.
Chest
|February 23, 1999
Summary
Pericardial effusions are common in HIV infection, with moderate to severe cases often unsuspected and potentially leading to tamponade. Echocardiographic surveillance is recommended for HIV patients with heart failure, Kaposi's sarcoma, or pulmonary infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- The pericardium is frequently affected in human immunodeficiency virus (HIV) infection.
- Characteristics and causes of pericardial abnormalities in HIV patients require further definition.
Purpose of the Study:
- To analyze pericardial involvement features in HIV-infected individuals.
- To identify clinical variables associated with moderate and severe pericardial effusions.
Main Methods:
- Prospective clinical and echocardiographic study.
- Involved 181 consecutive patients across all stages of HIV infection.
- Analyzed pericardial abnormalities and associated clinical factors.
Main Results:
- 41% of patients had asymptomatic pericardial effusion; 13% had moderate to severe effusions.
- Moderate to severe effusions were more common in symptomatic HIV patients (17% vs 2%).
- Independent predictors for moderate/severe effusions included heart failure, Kaposi's sarcoma, tuberculosis, and pulmonary infections.
Conclusions:
- Moderate to severe pericardial effusions in HIV patients are often clinically silent but can cause life-threatening tamponade.
- Echocardiographic surveillance is advised for HIV patients, particularly those with comorbidities like heart failure or specific infections.