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Determinants of HIV-related cardiac disease among adults in north central Nigeria
  1. Godsent Isiguzo1,
  2. Basil Okeahialam2,
  3. Solomon Danbauchi3,
  4. Augustin Odili4,
  5. Michael Iroezindu5
  1. 1Department of Internal Medicine, Federal Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria
  2. 2Department of Internal Medicine, Jos University Teaching Hospital, Jos, Plateau, Nigeria
  3. 3Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
  4. 4Department of Internal Medicine, College of Medicine, University of Abuja, Abuja, Federal Capial Teritory, Nigeria
  5. 5Department of Internal Medicine, College of Medicine, University of Nigeria Enugu Campus, Enugu, Enugu, Nigeria
  1. Correspondence to Dr Godsent Isiguzo, Internal Medicine Department, Federal Teaching Hospital, PMB 102 Abakaliki, Ebonyi State 400001, Nigeria; Isiguzogodsent{at}yahoo.com

Abstract

Objective The aim of the present study was to evaluate the determinants of HIV-related cardiac disease (HRCD) among adults in north central Nigeria. This was a hospital-based cross-sectional study recruiting patients who were HIV positive attending the HIV clinic at Jos University teaching Hospital, Nigeria.

Methods A total of 200 adults who were HIV positive and aged ≥18 years were consecutively recruited. All patients were administered a questionnaire and underwent clinical examination, laboratory investigation for haemoglobin estimation, CD4 cell count, viral load, serum lipid profile, hepatitis B surface antigen, anti-hepatitis C virus antibody, electrocardiogram and two-dimensional echocardiography Doppler studies. The outcome measure was echocardiography-defined cardiac disease, such as systolic dysfunction, diastolic dysfunction, isolated left ventricular dilatation, right ventricular dysfunction or pulmonary hypertension.

Results The mean age of the study population was 38±9 years. The majority (71%) were women and were on average younger than the men (36±8 years vs 47±9 years, p<0.0002). Highly active anti-retroviral therapy (HAART) use was seen in 84.4% of subjects. The median CD4 cell count for the study population was 358 cells/µL; the count was 459 (95% CI 321 to 550) cells/µL for subjects without HRCD and 193 (95% CI 126 to 357) cells/µL for subjects with HRCD (p<0.001). HAART-naive subjects with HRCD had a mean CD4 cell count of 121 cells/µL vs 200 cells/µL for those on HAART (p<0.01). CD4 cell count (OR = 0.25, 95% CI 0.15 to 0.45) and duration of diagnosis (OR=3.88, 95% CI 1.20 to 13.71) were the significant determinants of HRCD on multivariate analysis.

Conclusions Duration of HIV diagnosis and degree of immunosuppression were the significant determinants of HRCD. There is therefore a need to reduce cardiovascular morbidity in patients infected with HIV through early diagnosis/sustained use of HAART, early screening for HRCD and prompt intervention.

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