Publication:

Cardiovascular diseases in HIV infected children and adolescents on highly anti-retroviral therapy at the university of Abuja teaching hospital, Gwagwalada, Nigeria

Background Effect of prolong use of antiretroviral therapy and chronic HIV infection on cardiac performance of infected children and adolescents requires evaluation. We studied cardiac structure/functions, and troponin levels of these subjects on anti-retroviral therapy for > 6 months in our hospital.

Methods A cross sectional survey was conducted in our facility for the above objectives. Bio-data, time and type antiretroviral drugs, mode of transmission, weight, height, body-mass-index, echocardiogram, electrocardiogram, CD4, viral load, and troponin were done for all subjects.

Results Of a total of 126 subjects recruited, 66 (52.4%) were males. Their mean age, and duration on antiretroviral therapy was 14.1±3.1 (7, 18) years, and 7.2±2.9 (1, 14) years. Majority 69 (54.8%) were between 15-18 years, most 73 (57.9%) had BMI of <18 kg/m2, and 99 (78.6%) had vertical transmition. Their mean troponin-1 level was 2.0±1.6ng/ml. Abnormal echocardiogram and electrocardiogrm was detected in 41.3% and 38.1% of the subjects, with mild-systolic-dysfunction (11.9%), pulmonary-hypertension (11.1%) and left-ventricular-dysfunction (10.3%) as the commonest abnormal echocardiogram findings, and sinus-tachycardia 16 (12.7%), non-specific-ST-T abnormality 12 (9.5%), mild-right and left-ventricular-hypertrophy 4 (3.2%) as the commonest electrocardiogram abnormalities detected. Significant relationship was seen between troponin and the following variables; echocardiogram, chi2 36.95, p=0.0001; electrocardiogram, chi2 59.07, p=0.0001; body-mass-index chi2 13.63, p=0.001; 1st line antiretroviral therapy, chi2 21.187, p=0.001, 2nd line, chi2 19.978, p=0.002; CD4, chi2 6.896, p=0.032; and viral-load, chi2 7.515, p=0.023.

Conclusions There is high prevalence of cardiac abnormalities among the study subjects. Echocardiogram and electrocardiogram to be included in their baseline and follow-up care for early disease detection, and initiation of measures to halt its progression.