Impact of Highly Active Antiretroviral Therapy in HIV-positive Patients with Cardiac Involvement

Pugliese, A.; Isnardi, D; Saini, Andrea; Scarabelli, Tiziano M.; Raddino, Riccardo; Torre, Donato

doi:10.1053/jinf.2000.0672

Cited by 168 publications

(101 citation statements)

References 11 publications

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“…The rate of progression from left ventricular dysfunction to heart failure can be considerably slowed by HAART therapy [15]. Although there is no conclusive evidence that HAART reverses cardiomyopathy, it appears, however, that by preventing profound immunosuppression and the development of AIDS, heart muscle remain healthier [41][42][43]. Therefore, a major focus on prevention and treatment strategies for HIV-related heart disease in developing countries should include, among others, an aggressive campaign to get universal access to HAART.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic abnormalities and disease severity (based on CD4 count) in treatment-naive HIV positive patients

Olusegun‐Joseph¹,

Ajuluchukwu²,

Mbakwem³

et al. 2017

HIV & AIDS Review

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Purpose: Human immunodeficiency virus (HIV) infection may be associated with cardiac abnormalities. These abnormalities appear to be more frequent with disease progression. This study sought to examine the relationship between HIV disease severity in treatment-naive patients and cardiac abnormalities identified by echocardiography.Material and methods: 100 HIV-positive, treatment-naive patients, comprising 53 patients with CD4 count < 200/µl (AIDS group) and 47 patients with CD4 count ≥ 200/µl (non-AIDS group) without any traditional risk factors for cardiac disease were recruited for the study. Both groups had clinical and echocardiographic evaluation for cardiac abnormalities. Results:Of the 53 patients in the AIDS group, 11.5% had dilated cardiomyopathy (DCM), compared with none in the non-AIDS group (p = 0.018). Systolic dysfunction was higher in the AIDS group when compared with the non-AIDS group (42.3% and 17.0%, respectively; p = 0.006). Also, those in the AIDS had a significantly higher left ventricular end diastolic diameter index when compared with the non-AIDS group (2.87 ± 0.37 and 2.67 ± 0.29, respectively; p = 0.004). Furthermore, moderate to severe pericardial effusion was more frequent in the AIDS group, when compared with non-AIDS group (15.38% and 2.12%, respectively; p = 0.045). Diastolic dysfunction was also more frequent in AIDS group, although this did not achieve statistical significance (34.64% and 29.78%, respectively; p = 0.61). Conclusion:Cardiac abnormalities are more frequent with disease progression in HIV infected patients. Patients with more advanced disease (CD4 < 200/µl) had significantly more frequent systolic dysfunction, DCM, larger left ventricular dimension, and moderate to severe pericardial effusion than those with CD4 ≥ 200/µl.

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Section: Discussionmentioning

confidence: 99%

Echocardiographic abnormalities and disease severity (based on CD4 count) in treatment-naive HIV positive patients

Olusegun‐Joseph¹,

Ajuluchukwu²,

Mbakwem³

et al. 2017

HIV & AIDS Review

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“…One Italian study reported an almost 7-fold reduction of the prevalence of HIV-associated myocarditis from the pre-HAART era [Pugliese et al, 2000]. In that study there is no conclusive evidence that HAART reverses cardiomyopathy, but it does appear that by preventing profound immunosuppression and the development of AIDS, heart muscle remains healthier [Pugliese et al, 2000].…”

Section: Treatmentmentioning

confidence: 99%

“…By preventing opportunistic infections and reducing the incidence of myocarditis, HAART regimens have reduced the prevalence of HIV-associated myocarditis to about 30% [Barbaro 2005]. One Italian study reported an almost 7-fold reduction of the prevalence of HIV-associated myocarditis from the pre-HAART era [Pugliese et al, 2000]. In that study there is no conclusive evidence that HAART reverses cardiomyopathy, but it does appear that by preventing profound immunosuppression and the development of AIDS, heart muscle remains healthier [Pugliese et al, 2000].…”

Section: Treatmentmentioning

confidence: 99%

Myocarditis in HIV Positive Patients

Cambrea¹

2011

Myocarditis

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“…The introduction of highly active antiretroviral therapy (HAART) has significantly reduced the incidence of HIV related-myocarditis. On the other hand, in developing countries where the supply of HAART is limited, researchers have observed increase in prevalence of HIV associated cardiomyopathy (Pugliese et al, 2000).…”

Section: Etiologymentioning

confidence: 99%