Human Immunodeficiency Virus, Cardiac abnormalities on Echocardiogram and the use of Highly Active Antiretroviral Therapy in Nigerian Patients

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Background: An increasing relationship between HIV/AIDS, highly active anti – retroviral therapy (HAART) and cardiovascular diseases (CVD) have been noted over time. The occurrence of acquired immunodeficiency syndrome (AIDS) – associated heart disease found in post – mortem studies is notably higher than those diagnosed clinically implying that many HIV/AIDS patients may have cardiac abnormalities that are not diagnosed during their lifetime. This misdiagnosis persists even in the presence of dire consequences such as overt heart failure or even death.

Aim: This study set to determine what cardiac abnormalities are present in Nigerian HIV positive patients and what differences exist in the manifestations of these cardiac abnormalities between HIV positive patients who have been on HAART and those who are non-treated with HAART.

Methods: This was a cross-sectional analytical study with a comparison group in which two groups consisting of 76 HIV positive treatment naïve and 76 HIV positive HAART treated patients who met the inclusion criteria were sampled. The study protocol was reviewed and approved by the Research and Ethics Committee of the University of Benin Teaching Hospital, Benin City. All patients had an echocardiography done and data obtained was entered into and analyzed using the IBM-SPSS version 22.0. A p-value ≤ 0.05 was considered significant for all statistical comparisons done.

Results: Total prevalence of ECHO abnormalities was 91.4% in HIV Positive patients. Echocardiographic cardiac abnormalities were more prevalent in HAART treated patients [94.7%] than treatment naïve patients [ECHO = 88.2%]. The cardiac abnormalities found include increased LVMI, left ventricular diastolic dysfunction, increased left ventricular mass, pericardial effusion and abnormalities in left ventricular geometry. Pericardial effusion was more prevalent in treatment naïve patients with treatment naïve patients also noted to have the worst form of left ventricular geometry with over half having abnormal left ventricular geometric patterns compared to about 1/3rd in HAART treated patients.

Conclusion: Overall, HAART treated patients had cardiac abnormalities on echocardiogram than treatment naïve patients.