Cardiovascular Dysfunction in HIV-infected Children in a Sub-Saharan African Country: Comparative Cross-sectional Observational Study

Okoromah, Christy A. N.; Ojo, Oluwadamilola; Ogunkunle, O. O.

doi:10.1093/tropej/fmr009

Cited by 36 publications

(51 citation statements)

References 21 publications

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“…Ventricular dimensions and mass are large in PLHIV with HF in SSA, similar to findings from North America (65,76). Up to one-third of African HIV-infected children have LVSD (63,64). Cardiac dysfunction in HIV-exposed infants is identifiable shortly after birth in high-income countries (77).…”

Section: Epidemiology Of Hiv-associated Hf In Lmics In the Art Eramentioning

confidence: 99%

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

Bloomfield

Alenezi

Barasa

et al. 2015

JACC: Heart Failure

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Successful combination therapy for human immunodeficiency virus (HIV) has transformed this disease from a short-lived infection with high mortality to a chronic disease associated with increasing life expectancy. This is true for high- as well as low- and middle-income countries. As a result of this increased life expectancy, people living with HIV are now at risk of developing other chronic diseases associated with aging. Heart failure has been common among people living with HIV in the eras of pre- and post- availability of antiretroviral therapy; however, our current understanding of the pathogenesis and approaches to management have not been systematically addressed. HIV may cause heart failure through direct (e.g., viral replication, mitochondrial dysfunction, cardiac autoimmunity, autonomic dysfunction) and indirect (e.g., opportunistic infections, antiretroviral therapy, alcohol abuse, micronutrient deficiency, tobacco use) pathways. In low- and middle-income countries, 2 large observational studies have recently reported clinical characteristics and outcomes in these patients. HIV-associated heart failure remains a common cardiac diagnosis in people living with heart failure, yet a unifying set of diagnostic criteria is lacking. Treatment patterns for heart failure fall short of society guidelines. Although there may be promise in cardiac glycosides for treating heart failure in people living with HIV, clinical studies are needed to validate in vitro findings. Owing to the burden of HIV in low- and middle-income countries and the concurrent rise of traditional cardiovascular risk factors, strategic and concerted efforts in this area are likely to impact the care of people living with HIV around the globe.

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Section: Epidemiology Of Hiv-associated Hf In Lmics In the Art Eramentioning

confidence: 99%

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

Bloomfield

Alenezi

Barasa

et al. 2015

JACC: Heart Failure

View full text Add to dashboard Cite

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“…Among HIV-infected children aged 18 months to 12 years with no prior cardiac problems in a tertiary teaching hospital in Nigeria, although 84% were receiving HAART, 33.7% were found to have dilated cardiomyopathy and 14.5% had pericardial effusion ≥ 5.0 mm. [4] The US National Institutes of Health (NIH) Multicenter Pediatric HIV/AIDS Cohort Study (PHACS) found that among children receiving long-term HAART, 10% had an extreme left ventricle (LV) dimension, increased aortic valve area or diameter, or a reduction of left ventricular ejection fraction (LVEF). [5] Children with HIV infection had increased carotid intima-media thickness (cIMT) compared to normal children.…”

Section: Introductionmentioning

confidence: 99%

Echocardiography and carotid intima–media thickness among asymptomatic HIV-infected adolescents in Thailand

Chanthong

Lapphra

Saihongthong

et al. 2014

Aids

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“…The burden of cardiac dysfunction has been reportedly high among ART naïve children in Uganda and elsewhere [6–8]. There is paucity of data that elaborates on both conduction and functional cardiac abnormalities among ART experienced children in Uganda and other Sub Saharan African countries.…”

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confidence: 99%

Cardiac Dysfunction Among Ugandan HIV-infected Children on Antiretroviral Therapy

Namuyonga

Lubega

Musiime

et al. 2016

Pediatric Infectious Disease Journal

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Background Despite effective antiretroviral therapy (ART), HIV-infected children on treatment have been observed to have cardiac abnormalities. We sought to determine the prevalence, types and factors associated with cardiac abnormalities among HIV-infected Ugandan children on combination ART. Methods We carried out a cross-sectional study from July 2012 to January 2013, at Joint Clinical Research Centre among HIV infected children aged 1 to 18 years. Cardiac abnormalities were assessed using electrocardiography (EKG) and echocardiography. CD4 counts, viral load and complete blood count were performed at enrollment. The prevalence of cardiac abnormalities was determined using simple proportions with the associated factors ascertained using logistic regression. Results Among 285 children recruited, the median (IQR) age was 9 (6, 13) years, 54% were female; 72% were on first line cART. Their mean (±sd) CD4 count was 1092 (±868.7) cells/mm3; median (IQR) viral load was 20 (20, 76) copies/ml. 94% had adherence to ART of more than 95%. Cardiac abnormalities were detected in 39 (13.7%) children. The most common abnormalities by EKG and echocardiography were non specific T-wave changes (4.6%) and pericardial disease (thickened pericardium with or without pericardial effusion) (2.8%), respectively. No factor assessed was found to be significantly associated occurrence of cardiac dysfunction. Conclusions The prevalence of cardiac dysfunction among the HIV-infected children on ART was 13.7 % which was high, with non specific T wave changes and pericardial disease being the most frequent abnormalities observed. No factor assessed was found to be associated with cardiac dysfunction.

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Cardiovascular Dysfunction in HIV-infected Children in a Sub-Saharan African Country: Comparative Cross-sectional Observational Study

Abstract: Structural and functional abnormalities are prevalent in HIV-infected African children and therefore justify inclusion of routine echocardiography in their standard care.

Cited by 36 publications

References 21 publications

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries

Echocardiography and carotid intima–media thickness among asymptomatic HIV-infected adolescents in Thailand

Cardiac Dysfunction Among Ugandan HIV-infected Children on Antiretroviral Therapy

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