https://doi.org/10.4081/acbr.2022.186

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

Vol. 3 No. 1 (2022)
Submitted: 21 December 2021
Accepted: 9 February 2022
Published: 17 May 2022
Cardiac dysfunction, children, HIV/AIDS, echocardiography
Abstract Views: 705
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Authors

Ijeoma O. Arodiwe
ijeoma.arodiwe@unn.edu.ng
https://orcid.org/0000-0002-2733-6837
Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus /Teaching Hospital, Ituku – Ozalla, Enugu, Nigeria.
Christopher B. Eke
Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus /Teaching Hospital, Ituku – Ozalla, Enugu, Nigeria.
Ejikeme B. Arodiwe
Department of Medicine, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.

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.

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
Merson MH. The HIV–AIDS Pandemic at 25 - The Global Response. N Engl J Med 2006;354:2414-7. DOI: https://doi.org/10.1056/NEJMp068074
Bloomfield GS, Alenezi F, Barasa FA, et al. Human immunodeficiency virus and heart failure in low- and middle-income countries. J Am Coll Cardiol HF 2015;3:579–90. DOI: https://doi.org/10.1016/j.jchf.2015.05.003
Michael H, Lesly B. The child who is failing to grow. In: Seear M. Editor. A manual of tropical pediatrics Cambridge University Press 2010; p. 25-50.
Erqou S, Lodebo BT, Masri A, et al. Cardiac dysfunction among people living with HIV: a systematic review and meta-analysis. JACC: Heart Fail. 2019;7:98-108. DOI: https://doi.org/10.1016/j.jchf.2018.10.006
Austran B, Gorin I, Leibowitch M. AIDS in a Haitian woman with cardiac Kaposi’s sarcoma and Whipple disease. Lancet 1983;1:767-8. DOI: https://doi.org/10.1016/S0140-6736(83)92058-5
Shah 1, Prabhu SS, Shashikiran HS. Cardiac dysfunction in HIV infected children: a pilot study. Indian Paedtr 2005;42:46-9.
Brown SC, Schoeman CJ, Bester CJ. Cardiac findings in children admitted to a hospital general ward in South Africa: A comparism of HIV–infected and uninfected children. Cardiovasc JS Afr 2005;16:206-10.
Concorde Coordinating Committee. Concorde: MRC/ANRS randomised double-blind controlled trial of immediate and deferred zidovudine in symptom-free HIV infection. Lancet 2005;343:871–81. DOI: https://doi.org/10.1016/S0140-6736(94)90006-X
Oruamabo R. Viral infection. In: Azubuike JC, Nkanginieme KEO, Editors. Paediatrics and Child health in a Tropical Region, 2st ed. Owerri: African Educational Services. 2015: p. 402-409.
Brown SC, Schoeman CJ, Bester CJ. Cardiac findings in children admitted to a hospital general ward in South Africa: a comparism of HIV–infected and uninfected children. Cardiovasc JS Afr 2005;16:206-10.
Okoroma CAN, Ojo OO, Ogunkule OO. Cardiovascular dysfunction in HIV-infected children in a Sub-Saharan African Country: Comparative Cross-sectional Observational Study. J Trop Paediatr 2012;58:3-11. DOI: https://doi.org/10.1093/tropej/fmr009
Lubega S, Zirembusi GW, Lwabi P. Heart Disease among Children with HIV/AIDS attending the paediatric infectious disease clinic at Mulago Hospital. Afr Health Sci 2005;5:219-26.
Ram Y, Ellen GC. Acquired Immunodeficiency Syndrome (Human Immunodeficiency Virus). In: Behrman RE, Kliegman RM, Jenson HB, Editors; Nelson text book of pediatrics, 19th ed. Philadelphia: Saunders, 2012:1109-20.
Patel N, Abdelsayed S, Veve M, Miller CD. Predictors of clinically significant drug-drug interactions among patients treated with Non-nucleoside reverse transcriptase inhibitor-, protease inhibitor-, and raltegravir-based antiretroviral regimens. Ann Pharmacother 2011;45:317–24. DOI: https://doi.org/10.1345/aph.1P576
Obidike EO. Measurments. In: Obidike EO, Editor. Essentials of Clinical Methods in Paediatrics. 2nd ed. Institute For Development Studies Enugu 2011:109-15.
ACC/ AHA/ASE 2003 guidelines update for the clinical application of echocardiography: A report of the American College of Cardiology/ American Heart Association Taskforce on Practice guidelines. Circulation 2003:1108-1146.
Neri D, Somarriba GA, Schaefer NN, et al. Growth and body composition of uninfected children exposed to human immunodeficiency virus: comparison with a contemporary cohort and United States national standards. J Pediatr 2013;163:249-54.e1-2. DOI: https://doi.org/10.1016/j.jpeds.2012.12.034
Shah 1, Prabhu SS, Shashikiran HS. Cardiac dysfunction in HIV infected children: a pilot study. Indian Paedtr 2005;42:46-9.
Mas CM, Miller TL, Cordero C, et al. The effects of fetal and childhood exposure to antiretroviral agents. J AIDS Clin Res 2011;S2:001.
Eneh AU. Human immune deficiency virus AIDS. In: Azubuike JC, Nkanginieme KEO, Editors. Paediatrics and Child health in the tropical Region, 2nd ed. Owerri: African Educational Services. 2007: p. 643-653.
Fisher SD, Kanda BS, Miller TL, Lipshultz SE. Cardiovascular disease and therapeutic drug-related cardiovascular consequences in HIV-infected patients. Am J Cardiovasc Drugs 2011;11:383–394. DOI: https://doi.org/10.2165/11594590-000000000-00000
Lipshultz SE, Shearer WT, Thompson B, et al. Cardiac effects of antiretroviral therapy in HIV-negative infants born to HIV-positive mothers: NHLBI CHAART-1 (National Heart, Lung, and Blood Institute Cardiovascular Status of HAART Therapy in HIV-Exposed Infants and Children cohort study) J Am Coll Cardiol 2011;57:76–85.
Lobato MN, Caldwell B, Ng P, Oxtoby MJ. Encephalopathy in children with perinatally acquired human immunodeficiency virus infection. J Paediat 1995;126:710-5. DOI: https://doi.org/10.1016/S0022-3476(95)70397-7
Herskowitz A, Wu TC, Willoughby SB. Myocarditis and cardiotropic viral infection associated with severe left ventricular dysfunction in late-stage infection with human immunodeficiency virus. J Am Coll Cardiol 1994;24:1025-32. DOI: https://doi.org/10.1016/0735-1097(94)90865-6
Lipshultz SE, Mas CM, Henkel JM, et al. HAART to heart: highly active antiretroviral therapy and the risk of cardiovascular disease in HIV-infected or exposed children and adults. Exp Rev Anti Infect Ther 2012;10:661–74. DOI: https://doi.org/10.1586/eri.12.53

How to Cite

Arodiwe, I. O., Eke, C. B., & Arodiwe, E. B. (2022). Predictors of cardiac dysfunction in children with HIV/AIDS attending University of Nigeria Teaching Hospital Enugu. Annals of Clinical and Biomedical Research, 3(1). https://doi.org/10.4081/acbr.2022.186

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