High Burden of Cardiac Abnormalities in Adults with HIV in Ethiopia: A Multicenter Cross-Sectional Study

ObjectivesTo estimate the prevalence and patterns of cardiac abnormalities among adults with HIV attending antiretroviral therapy clinics in Ethiopia and to identify clinical predictors of dilated cardiomyopathy (DCM).MethodsA multicenter cross-sectional study enrolled 312 adults with HIV from three tertiary hospitals in Addis Ababa. All participants underwent transthoracic echocardiography and standardized clinical assessment; multivariable logistic regression identified independent predictors of DCM.ResultsEchocardiographic abnormalities were detected in 42.1% of participants, including diastolic dysfunction (8.9%), left ventricular hypertrophy (8.9%), systolic dysfunction (6.1%), DCM (5.4%), coronary artery disease (3.9%), pericardial effusion (2.5%), and pulmonary hypertension (1.4%). DCM was independently associated with CD4 < 200 cells/mm³, antiretroviral therapy-naïve status, and BMI <18.5 kg/m².ConclusionsEthiopian adults with HIV had a high burden of largely asymptomatic cardiac disease. Integrating targeted echocardiographic screening into routine HIV care, prioritizing patients with advanced immunosuppression, lack of ART, or malnutrition, may improve early detection and management.