Association of CD4 Counts with Cardiovascular Dysfunction among HIV/AIDS Patients - A Hospital Based Study in North Karnataka

Abstract

BACKGROUND Globally the number of people living with human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) has been rising steadily since 2011 nearing more than 33 million whereas in developing countries like India it is 2.4 million with a prevalence of 0.3%. The purpose of this study was to assess the association of CD4 counts with cardiovascular dysfunction among HIV/AIDS patients. METHODS This was a hospital-based study conducted at the Vijayanagara Institute of Medical Sciences, Bellary. Convenience sampling was used and patients admitted to the wards of the internal medicine as well as those attending anti-retroviral therapy (ART) centre out-patient department (OPD) were included in the study. A total of 200 cases of seropositivity of HIV patient diagnosed by Elisa technique were assessed after obtaining informed consent. Clinical profile and laboratory investigations were carried out on the patients such as CD4 counts and analyzed with various cardiac dysfunction. RESULTS Commonest affected with HIV infection were young male (26 – 40 years) 77.5 % followed by young female 60 % Commonest symptoms were fever, cough 82 % each and breathlessness 44 %. Commonest clinical findings were pallor 80 %, pedal oedema 68 %, and lymphadenopathy 32 %. 26 % of patients had electrocardiography (ECG) abnormalities with commonest being sinus tachycardia 18 %, low voltage complex 4 %, IHD (ischemic heart disease) 2 %, LVH (left ventricular failure) 2 %. 34 % had chest x-ray abnormalities such as cardiomegaly 14 %, pleural effusion 12 % and PTB (pulmonary tuberculosis) 2 %. Abnormal CD4 counts were noted in 94 % of patients, with 12 % having very low CD4 counts that is less than 50. Statistically significant pericardial effusion was noted with low CD4 counts on 2D ECHO cardiography. CONCLUSIONS The study concludes that decrease in CD4 count is statistically associated with increased pericardial effusion among HIV/AIDS patients. KEYWORDS CD4 Counts, HIV/AIDS Patients, Cardiovascular Dysfunction, Pericardial Effusion