Prevalence and patterns of cardiac disorders among adults attending antiretroviral follow up clinic at Jimma University Specialized Hospital, Jimma, Southwest Ethiopia

Abstract

Background: Cardiac diseases are among common complications of HIV infection. The commonly encountered forms of heart diseases among HIV-infected individuals include dilated cardiomyopathy(DCM), coronary artery diseases(CAD), pericardial effusion, pulmonary hypertension, and left ventricular diastolic and systolic dysfunctions. The magnitude of the problem had been reported from other countriesbut there is no study that evaluated the prevalence and patterns of HIV-associated cardiac disorders in Ethiopia. This study was conducted to determine the prevalence, patterns and factors that are associated with cardiac diseases among adults with HIV/AIDS attending antiretroviral therapy (ART) follow up clinic. Materials and Methods: A cross sectional hospital based study was conducted on 280 HIVinfected sampled adults attending antiretroviral follow up clinic at Jimma University Specialized Hospital from September 16, 2012 -July15, 2013. Structured questionnaire was used to retrieve information on socio-demographic characteristics of participants, symptoms of heart failure, duration since the participants knew their HIV sero-status and CD4+ counts. A detailed transthoracic Echocardiography was performed for all the participants. The data were edited, entered into, cleaned and analyzed using SPSS for windows version 16 of the computer software. Independent variables were assessed for association with the cardiovascular disease using bivariate and multivariate logistic regression analyses to generate odds ratios. A P value of less than 0.05 was used to define statistical significant. Results: A total 280 participants included in the study; 185(66.1%) were females and 173(64.7%) were on ART. The mean (±sd) age of the participants was 33.62±8.29 years and the mean CD4 count was385.57±237.44. Cardiac abnormalities were found among 119 (42.1%) of individuals; the most common forms being diastolic dysfunction and left ventricular hypertrophy (LVH), each accounting for 8.9%; while DCM was found among 5.4% of the cases. DCM was significantly associated with lower CD4 counts (p<0.002), not starting on ART (p<0.05) and lower Body mass index (BMI) (p<0.05). Pericardial effusion was found among 2.5% of the individuals and was significantly associated with ART status (p<0.05). Conclusion:-The study came up with high prevalence of cardiac abnormalities. The prevalence of DCM was found to be significantly higher among patients with low CD4 counts, poor nutritional status and among those who did not start ART