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Category: Volume 08 Issue 02 February 2020
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Title: Cardiac manifestations in HIV patients and their correlation with CD4 count

Authors: Piyush Saxena, Sujeet Kumar, Santosh Maurya

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.134

Abstract

   

Introduction: The introduction of highly active antiretroviral therapy (HAART) has significantly improved the clinical evolution of human immunodeficiency virus (HIV)/AIDS disease, with an increased survival of infected patients. With advances in the management of patients living with HIV and AIDS , not only survival has increased but manifestations of late stage HIV infection are encountered more often including cardiovascular complications.

Aims and Objectives: 1.To determine the prevalence and characteristics of cardiac manifestations in patients with HIV infection.  2. To correlate the cardiac manifestations with CD4 count.  

Materials and Method: 115 HIV-positive cases and 30 healthy control subjects were evaluated by detailed history and general physical examination. CD4 was done for all patients using flowcytometry using a BD FACS Count system. All patients were evaluated using M Mode and two dimensional transthoracic echocardiography and colour flow doppler examination.  

Results: Male to female ratio was1.6:1in cases. The most common symptoms were cough (54.78%), palpitations (10%) ,shortness of breath (52%),chest pain on exertion(18.0%) and ankle swelling (21.0%). Echocardiographic abnormalities were found in 63% of the cases compared with 6% in the controls. 18 (15.65%) patients  had dilated cardiomyopathy ,17(15%)  pericardial effusion,16(14%) pulmonary artery hypertension,17(15%)  mitral valve prolapse and 25(22%) had reduced ejection fraction compared with none of controls. 54(47%) cases had diastolic dysfunction compared with 3(10%) controls and 40(35%) cases had reduced fractional shortening(≤27%) compared 4(13%) controls.  Significant statistical positive correlation was not observed between low CD4 count and echocardiographic abnormalities. Pericardial effusion was seen more in patients with CD4 count below 200 

Conclusions: Cardiovascular abnormalities in HIV infected patients are common and can occur without any clinical manifestation. There was no significant association between CD4 count and any cardiac manifestation.

Keywords: Vitamin D levels, diabetes complications, type 2 DM, retinopathy.

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Corresponding Author

Piyush Saxena

Associate Professor, Department of Medicine, Motilal Nehru Medical College, Prayagraj