Publication:

Study of cardiac manifestations in people living with HIV using echocardiography and association with CD-4 counts and other factors

Background As the AIDS related deaths have declined, due to introduction of ART, the survival of people living with HIV (PLWH) has increased, leading to increased prevalence of chronic conditions like cardiovascular diseases. India has the second highest burden of HIV-AIDS globally so there is a need for studying cardiovascular diseases in this population. Present study was undertaken to study the cardiac manifestations in people living with HIV using echocardiography and other tools and their correlation with CD4-counts and other factors.

Methods A cross-sectional study was done on 200 patients divided into two equal groups based on HIV-ELISA status. Known cases of coronary heart disease, structural and valvular heart disease were excluded. Participants underwent basic investigations, chest X ray, ECG, TMT, NTProBNP and echocardiography. PLWH also had their CD4-counts measured. A statistical analysis was performed and the prevalence of cardiovascular abnormalities and presence of related associations was sought.

Results 26% of PLWH showed abnormal echocardiography with prevalence odd’s ratio of 3.16 when compared to non-HIV group.  Diastolic dysfunction was the most common abnormality found. Older age (>50 years), presence of comorbidities, low CD4 counts, advanced WHO staging, non-intake of ART and presence of opportunistic infections were positively and significantly associated with echocardiographic abnormalities in PLWH.

Conclusions There is high prevalence of cardiovascular diseases among PLWH. Echocardiography may be used as screening tool. Newer ART regimens and High CD4-counts seem to be cardioprotective. There is need for further prospective studies on larger scale to accurately determine associated risk factors.