Cardiac Dysfunction Among Nigerian HIV-Infected Children on Antiretroviral Therapy in a Tertiary Center

Abstract

Background: Cardiac dysfunctions have been seen in HIV/AIDS children on antiretroviral therapy (ART). This contributes to increased mortality. There is a dearth of information on cardiac dysfunctions in African children. Objectives: We investigated the types of cardiac dysfunctions in HIV/AIDS and its associated factors in children on ART. Materials and Methods: Echocardiography was performed on 90 children with HIV/AIDS using SONO 2000 machine with 5.5—12 MHz transducer. The reliability score of the machine is 95%. The prevalence of cardiac dysfunctions was determined using proportions and associated factors using logistic regression. Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. Results: Cardiac dysfunctions were significantly higher in the anti retroviral therapy group than the ART-naive group. It was seen in 52.0 (81.0%) of patients on anti retroviral therapy and in 10.0 (38.1%) of ART-naive patients, P = 0.01. The significant ones were left ventricular (LV) diastolic dysfunction in 38.5% (P = 0.02); LV systolic dysfunction in 19.2% (P = 0.03); LV dilatation in 15.4% (P = 0.01), pericardial effusion 7.7% (P = 0.04), and dilated cardiomyopathy in 3.8% (P = 0.13). A linear relationship between cardiac dysfunctions and CD4+ cell counts and age of patients was noted. The highest coefficient of determination (R 2) = 0.8642 was associated with CD4+ cell counts, followed by the age of patients R 2 = 0.4203. Conclusion: The prevalence of cardiac dysfunctions was high. Using echocardiography, cardiac dysfunctions were more likely to be detected early. It is, therefore, recommended that baseline and periodic echocardiography should be part of the management of these children.