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Cardiac involvement in HIV infected people in Yaounde, Cameroon
D Nzuobontane1, K N Blackett, C Kuaban
1Wirral Hospital Trust, St Catherine's Hospital, Birkenhead, Merseyside, UK. divinenz@hotmail.com
Insights
Cardiac abnormalities are common in African HIV patients, particularly dilated cardiomyopathy in those with low CD4 cell counts. These findings highlight the need for increased cardiac monitoring in HIV care.
Area of Science:
- Cardiology
- Infectious Diseases
- Immunology
Background:
- Cardiovascular complications are increasingly recognized in Human Immunodeficiency Virus (HIV) infection.
- Understanding the spectrum and prevalence of cardiac abnormalities in HIV-infected individuals is crucial for patient management.
Purpose of the Study:
- To investigate cardiac abnormalities in HIV-infected patients.
- To correlate these abnormalities with the clinical stage of HIV disease and immunological status (CD4 cell count).
Main Methods:
- Seventy-five patients were recruited and classified as AIDS, HIV-positive non-AIDS, or HIV-negative.
- Echocardiography (two-dimensional and M-mode) and blood lymphocyte typing (CD4 counts) were performed on all participants.
Main Results:
- Dilated cardiomyopathy was observed in 23.33% of AIDS patients and 4.17% of HIV-positive non-AIDS patients.
- Dilated cardiomyopathy showed a significant association with low CD4 cell counts (< or =100/mm³).
- Other echocardiographic findings included pericardial effusion and mitral valve prolapse, though not statistically significant.
Conclusions:
- Cardiovascular abnormalities are frequent in African HIV-infected patients, often presenting subtly.
- Low CD4 cell counts are a significant risk factor for dilated cardiomyopathy in this population.
- Cardiologists should anticipate a higher incidence of these abnormalities as HIV management improves.
Objective:
To study the cardiac abnormalities in HIV infected patients in relation to the clinical stage of the disease and the immunological status of the patients.
Methods:
A total 75 consecutive patients tested for HIV on the basis of clinical suspicion of the disease from July to September 1996 at the University Hospital Centre, Yaounde, Cameroon were recruited. The patients were classified into AIDS, HIV positive non-AIDS, and HIV negative according to clinical findings and outcome of ELISA and western blot testing. Every patient underwent a clinical examination, two dimensional and M-mode echocardiography, and blood lymphocyte typing.
Results:
Dilated cardiomyopathy occurred in 7/30 (23.33%) AIDS patients, 1/24 (4.17%) HIV positive non-AIDS patient, but in none of the HIV negative patients. Other echocardiographic abnormalities included pericardial separation, effusion, thickening, and mitral valve prolapse. Although these abnormalities were more frequent in HIV infected patients, the differences did not reach levels of statistical significance. Dilated cardiomyopathy occurred in six (31.58%) of the patients with a CD4 cell count < or =100/mm(3) and two (6.06%) in those with absolute CD4 counts >100/mm(3) (chi(2) = 4.02, p = 0.03).
Conclusions:
Cardiovascular abnormalities are frequent in African HIV infected patients but clinically discrete. Low CD4 cell counts are associated with dilated cardiomyopathy. These abnormalities should be expected with greater frequency in cardiological clinical practice as management of opportunistic infections improves in a situation of continued high disease prevalence in Africa.