A study of cardiac dysfunction in human immunodeficiency virus-infected patients and its correlation with cd4 count

Abstract

Introduction: Human immunodeficiency virus (HIV) is an infectious disease, leading to rapid failure of the immune system. Since the introduction of combination antiretroviral therapy (ART), it has led to a substantial decrease in the incidence of AIDS-related conditions and all-cause mortality over time. However, clinical chronic nonAIDS conditions including cardiovascular disease are on a rise with the prolonged life expectancy of HIV-infected patients. Study Design: The study design involves hospital-based observational comparative analysis.Materials and Methods: A total of 200 individuals, including 100 infected with HIV and 100 controls, were taken after ruling out the various exclusion factors. Cases were further scrutinized on the basis of CD4 count and duration of highly active ART. Every patient underwent a battery of tests, and also various echocardiography parameters were recorded and analyzed carefully. Results: Male:female ratio in cases and controls was 3.3:1. Cases were divided according to CD4 count, as patients having CD4 350. The mean CD4 count was 108.47 ± 36.51/277.85 ± 46.73/576.63 ± 195, respectively. Forty-one percent of individuals had abnormal electrocardiography findings, pulmonary hypertension (PH) was found in 10% of patients, and also three patients (30%) had a moderate grade of PH. Twenty-seven percent had minimal pericardial effusion. Among cases, the mean ejection fraction observed was 54.68% ± 6.82% which was significantly lower than controls (60.72% ± 1.47%). Left ventricular diastolic dysfunction was seen in 46% of cases as compared to 3% controls. Conclusions: This study indicates that cardiovascular abnormalities are more common in HIV-infected patients than the normal population. Even asymptomatic patients had abnormal echocardiographic findings. Echocardiography is a useful noninvasive technique for the early recognition of cardiac dysfunction in such patients.