Abstract
ObjectivePeople living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. However, there is scant evidence of the echocardiographic changes that occur shortly after seroconversion. In this study we describe the echocardiographic evaluations of asymptomatic US Air Force members who were diagnosed with HIV infection and evaluated at the San Antonio Military Medical Center between September 1, 2015 and September 30, 2016.ResultsPatients (n = 50) were predominantly male (96%), mostly African American (60%), with a mean age of 28 years. At HIV diagnosis, the mean viral load was 112,585 copies/mL and CD4 count was 551 cells/μL. All were found to have normal left ventricular systolic ejection fraction (EF) and global longitudinal strain (GLS) however evidence of right ventricular dilatation and left ventricular remodeling was observed in 7 (14%) and 13 (26%) patients, respectively. Subgroup analyses showed no significant differences in echocardiographic findings by HIV disease severity or CVD risk factors (p > 0.05 for all).This study suggests that untreated HIV may have a low impact on the development of echocardiographic abnormalities shortly after seroconversion. Longitudinal studies are warranted to determine the optimal CVD risk assessment strategies for PLHIV.
Highlights
Over the past 2 decades, advances in human immunodeficiency virus (HIV) care has improved the life expectancy of people living with HIV (PLHIV)
We describe the findings of non-invasive cardiovascular health evaluations performed during the initial medical assessment of asymptomatic US Air Force (USAF) members with early HIV infection prior to the initiation of anti-retroviral therapy (ART)
Asymptomatic, ART-naïve patients evaluated with echocardiography soon after HIV acquisition were not found to have evidence of systolic dysfunction or reduced global longitudinal strain
Summary
A total of 50 patients were evaluated during the study period. Patients were predominantly male (96%) with a mean age of 28 years ± 7.14 at HIV diagnosis. African American Caucasian Other Body-mass index (kg/m2) Obese Active smoker Hypertension Diabetes mellitus Hyperlipidemia Family history of cardiovascular disease hs-CRP (mg/dL) NT-proBNP (pg/mL) Echocardiographic findings Left ventricle LV ejection fraction (%) GLS (%) LV remodelinga LV diastolic dysfunction Indexed LV mass (g/m2) Interventricular septal diameter (mm) Relative wall thickness Right ventricle Indexed RV area (cm2/m2) FAC (%) RV dilatationb LV diastolic function Indexed LA volume (cm2/m2) Septal e′ velocity (cm/s) Lateral e′ velocity (cm/s) Average E/e′ Pulmonary artery systolic pressure (mmHg) HIV disease characteristics CD4 count (cells/μL) HIV viral load (copies/mL)c AIDS diagnosisd Time from last HIV negative test to first positive.
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