Predictors of cardiac dysfunction in children with HIV/AIDS attending University of Nigeria Teaching Hospital Enugu

Abstract

Cardiac dysfunction, though common as a primary effect of HIV infection or its treatment in HIV-infected children, is often clinically masked by pulmonary disease in patients with HIV infection and AIDS. The objective of the study was to determine the prevalence and predictors of cardiac dysfunction in children with HIV/AIDS infection. This was a cross-sectional comparative case - control study of clinical and echocardiographic findings in 90 pediatric HIV/AIDS children aged 18 months to 14years and their age and gender - matched HIV – negative controls attending the University of Nigeria Teaching Hospital, Enugu. Relevant clinical information including demographics, investigations including echocardiography and treatment, were captured using a datasheet designed for the study. Data analysis was done using SPSS version 20.0. A p value of <0.05 was considered significant. The majority of the subjects had cardiac abnormalities and was on HAART. The pattern of cardiac abnormalities in HIV – infected and AIDS groups were left ventricular diastolic dysfunction (33.8% and 36.4% in the HIV – infected and the AIDS groups respectively, followed by dilated cardiomyopathy (6.8%) seen only in AIDS group (p=0.03). A strong linear relationship between cardiac dysfunction and CD4+ counts (R2=0.8642) and age (R2=0.4203) among the patients were observed. Cardiac dysfunction is common in children with HIV/AIDS and predicted by CD4+ count and increasing age. Need exists to monitor the development of cardiac dysfunction using appropriate clinical details and echocardiography is recommended to improve their quality of life.