Cardiac size and systolic function of HIV-infected Lagos children accessing routine care: a pilot study

Abstract

Background: Previous studies have reported high, though declining, prevalence of HIV-associated cardiac dysfunction globally. However, there is relative paucity of data on the prevalence and pattern of HIV-associated cardiac disorders in Nigerian children. The index study aimed to conduct a pilot evaluation of the frequency and pattern of cardiac dysfunctions in HIV-infected children in a tertiary health facility in Lagos, Nigeria. Methods: Thirty-nine HIV-infected children, with 41 age- and sex-matched controls, were prospectively recruited in a cross-sectional study. Subjects had echocardiography to obtain measures of cardiac dimensions and function. Subjects’ anthropometry, blood pressure and clinical profile were also obtained. Results: HIV-infected children had significantly thicker interventricular septal diameter (IVSD) (P=0.0018) and larger left atrial diameter (P=0.003) and aortic root diameter (P=0.023); other parameters (right ventricular diameter, left ventricular diameter, left ventricular posterior wall diameter, left ventricular mass (LVM), ejection fraction, fractional shortening) were similar between both groups. There was no significant difference in the prevalence of LVH between those on zidovudine-based regimen compared to those on non-zidovudine-based regimen (P=0.703). Conclusions: The prevalence of subclinical echocardiographic abnormalities was high and was more in those below five years of age. In a setting of limited resources, this age group may be prioritized for serial monitoring of cardiac abnormalities.