ORIGINAL ARTICLE

Cardiac involvement in HIV infected people in Yaounde, Cameroon

D Nzuobontane¹, K N Blackett², C Kuaban³

¹ Wirral Hospital Trust, St Catherine’s Hospital, Birkenhead, Merseyside, UK
² University Hospital Centre, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
³ Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon

Correspondence to:
Correspondence to:
Dr Divine Nzuobontane, Wirral Hospital Trust, St Catherine’s Hospital, Birkenhead CH42 0LQ, UK;
divine.nzuobontane{at}exchange.nwest.wirral-ha.nhs.uk or divinenz{at}hotmail.com

Objective: To study the cardiac abnormalities in HIV infected patients in relation to the clinical stage of the disease and the immunological status of the patients.

Methods: A total 75 consecutive patients tested for HIV on the basis of clinical suspicion of the disease from July to September 1996 at the University Hospital Centre, Yaounde, Cameroon were recruited. The patients were classified into AIDS, HIV positive non-AIDS, and HIV negative according to clinical findings and outcome of ELISA and western blot testing. Every patient underwent a clinical examination, two dimensional and M-mode echocardiography, and blood lymphocyte typing.

Results: Dilated cardiomyopathy occurred in 7/30 (23.33%) AIDS patients, 1/24 (4.17%) HIV positive non-AIDS patient, but in none of the HIV negative patients. Other echocardiographic abnormalities included pericardial separation, effusion, thickening, and mitral valve prolapse. Although these abnormalities were more frequent in HIV infected patients, the differences did not reach levels of statistical significance. Dilated cardiomyopathy occurred in six (31.58%) of the patients with a CD4 cell count 100/mm³ and two (6.06%) in those with absolute CD4 counts >100/mm³ (² = 4.02, p = 0.03).

Conclusions: Cardiovascular abnormalities are frequent in African HIV infected patients but clinically discrete. Low CD4 cell counts are associated with dilated cardiomyopathy. These abnormalities should be expected with greater frequency in cardiological clinical practice as management of opportunistic infections improves in a situation of continued high disease prevalence in Africa.

Keywords: HIV; cardiac involvement; dilated cardiomyopathy

Abbreviations: HAART, highly active antiretroviral therapy; LVEDD, left ventricular end diastolic diameter; LVEDV, left ventricular end diastolic volume; LVESD, left ventricular end systolic diameter; LVESV, left ventricular end systolic volume; LVFS, left ventricular fractional shortening

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This article has been cited by other articles:

• Mayosi, B. M (2007). Contemporary trends in the epidemiology and management of cardiomyopathy and pericarditis in sub-Saharan Africa. Heart 93: 1176-1183 [Abstract] [Full Text]  
• Ntsekhe, M., Hakim, J. (2005). Impact of Human Immunodeficiency Virus Infection on Cardiovascular Disease in Africa. Circulation 112: 3602-3607 [Abstract] [Full Text]  
• (2003). Heart disease is the next hurdle for HIV positive Africans surviving concurrent infections. Sex. Transm. Infect. 79: 219-219 [Full Text]  

eLetters:

Read all eLetters

Cardiac involvement in HIV-infected people in Cameroon

Giuseppe Barbaro

Postgrad Med J Online, 23 Jan 2003 [Full text]

Cardiac involvement in HIV infected people in Cameroon

Divine Nzuobontane

Postgrad Med J Online, 5 Feb 2003 [Full text]