Pericardial disease and human immunodeficiency virus in Dar es Salaam, Tanzania

Abstract

The number of patients admitted to Muhimbili Medical Centre, Tanzania, with pericardial effusions rose after the epidemic of acquired immunodeficiency syndrome (AIDS) began. To investigate a possible relation all patients with suspected pericardial disease admitted between Oct 1, 1987, and March 31, 1989, were studied. 28 of 42 patients (67%) were seropositive for human immunodeficiency virus (HIV). 28 of 39 patients (72%) with pericardial effusion were HIV-seropositive compared with 0 of 3 without effusion. More HIV-seronegative than HIV-seropositive patients were receiving anti-tuberculous chemotherapy and had ascites at enrolment. Only 5 of 28 HIV-seropositive patients had clinical signs of AIDS. 9 of 14 HIV-seropositive patients tested had positive Mantoux tests. There were no significant differences between the HIV-seropositive and seronegative groups in the duration of symptoms, laboratory results, X-ray or ultrasound findings, frequency of tamponade, or mortality. 38 patients were treated for tuberculosis. Pericardial effusion is stronly associated with, and an early manifestation of, HIV infection in Tanzania.