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HIV as a risk factor for cardiac disease in Botswana: a cross-sectional study

Thomas Schwartz1, Girgis Magdi, Tore W Steen

  • 1Institute for Experimental Medical Research, Oslo University Hospital, Oslo, Norway.

International Health
|September 14, 2013
PubMed

Insights

HIV significantly increases the risk of heart disease, particularly cardiomyopathy and pericarditis, in Botswana. The cardiothoracic ratio on chest X-rays can help screen for severe cardiac conditions in resource-limited settings.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • HIV infection is a global health concern with significant cardiovascular implications.
  • Understanding the spectrum of heart disease in HIV-positive populations is crucial for effective management.
  • Botswana faces a high HIV prevalence, necessitating research into its impact on cardiac health.

Purpose of the Study:

  • To investigate the influence of HIV on heart disease patterns in Botswana.
  • To determine HIV prevalence among patients with cardiomegaly.
  • To assess the utility of the cardiothoracic ratio (CT ratio) on chest radiography (CXR) as a cardiac screening tool.

Main Methods:

  • Retrospective analysis of 179 patients with cardiomegaly (CT ratio >0.53) and known HIV status.
  • Clinical examination and echocardiography were performed.
  • HIV prevalence was compared to the general population; associations between HIV and specific cardiac conditions were calculated using relative risk (RR).

Main Results:

  • Cardiomyopathy (36.9%), pericarditis (21.2%), and hypertensive heart disease (14.0%) were the primary causes of cardiomegaly.
  • HIV prevalence in the study group (59%) was substantially higher than in the general population (25%).
  • HIV infection showed a strong association with pericarditis (RR 3.3) and cardiomyopathy (RR 2.9).

Conclusions:

  • HIV-infected patients in Botswana have an elevated risk of non-ischaemic heart diseases, especially cardiomyopathy and pericarditis.
  • The CT ratio on CXR demonstrates high specificity for severe heart disease, serving as a valuable screening tool in resource-limited areas.
  • This study highlights the critical need for integrated HIV and cardiac care in Botswana.

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