Abstract
Introduction
Human immunodeficiency virus is a retrovirus that affects all systems in the body. Among this cardiovascular disease is one of the leading causes of non HIV related death in HIV patients. Risk factors for cardiovascular disease in HIV patients include traditional risk factors, chronic inflammation associated with HIV infection and metabolic effects of antiretroviral therapy. HIV infection itself is a independent risk factor for cardiovascular diseases.
HIV infection increases the production of various cytokines which are toxic to myocytes and thereby increases the risk of cardiovascular complications. HIV infection induced endothelial dysfunction and vasculitis is also playing an important role in pathogenesis of these complications.
Although many cardiovascular complications have been described like pulmonary hypertension, systemic hypertension, infective endocarditis and accelerated atherosclerosis in hiv patients, the most common complications include diastolic dysfunction, left ventricular systolic dysfunction ,pericardial effusion, dilated cardiomyopathy and coronary artery disease. Rapid onset congestive heart failure leads to death in HIV patients within 6 to 12 months of diagnosis.
As the disease progresses the CD4 count declines which increases the cardiovascular complications leading to death. So echocardiographic screening should be performed in all HIV patients with low CD4 count for early detection and management of the complications.
This study was conducted to study the prevalence of cardiac complications in HIV patients and their correlation with CD4 count.
References
- Kaul, M. C. Fishbein and R. J. SIEGEL, “Cardiac Manifestations of Acquired Immune Deficiency Syndrome,” American Heart Journal, Vol. 122, No. 2, 1991, pp. 535- 544. doi: 10.1016/0002-8703(91)91013-D
- Corallo, M. R. Mutinelli, M. Moroni, et al., “Echocar- diography Detects Myocardial Damage in AIDS,” Euro- pean Heart Journal, Vol. 9, No. 8, 1998, pp. 887-892.
- Aggarwal, A. Sharma, R. Bhardwaj and R. Rainam, “Myocardial Dysfunction in Human Immunodeficiency virus Infection: An Echocardiographic Study,” Journal of the Association of Physicians of India, Vol. 57, 2009, pp. 745-746.
- Anita, et al., “Cardiac Dysfunction Associated with HIV Infection,” Journal of the Association of Physicians of India, Vol. 51, 2003, p. 1182.
- Moreno, J. P. Villacastin, H. Bueno, et al., “Clinical and Echocardiographic Findings in HIV Patients with Pericardial Effusion,” Cardiology, Vol. 88, No. 5, 1997, pp. 397-400. doi: 10.1159/000177367
- M. Pellicelli, G. Barbaro, F. Palmieri, E. Girardi, C. D’Ambrosio, A. Rianda, G. Barbarini, D. Frigiotti, M. C. Borgia and N. Petrosillo, “Primary Pulmonary Hypertension in HIV Patients: A Systematic Review,” Angiology, Vol. 52, No. 1, 2001, pp. 31-41.
- Klein, L. B. Hurley, C. P. Quesenberry Jr. and S. Sid-ney, “Do Protease Inhibitors Increase the Risk for Coro-nary Heart Disease in Patients with HIV-1 Infection,” Journal of Acquired Immune Deficiency Syndromes, Vol. 30, No. 5, 2002, pp. 471-477.
- Castro, G. Migliau, A. Silvestri, et al., “Heart Involvement in AIDS: A Prospective Study during Various Stages of Diseases,” European Heart Journal, Vol. 13, 1992, pp. 1452-1459.
- B. Himelman, W. S. Chung, D. N. Chernoff, N. B. Schiller and H. Hollander, “Cardiac Manifestations of Human Immunodeficiency Virus Infection: A Two-Di- mensional Echocardiographic Study,” Journal of the American College of Cardiology, Vol. 13, No. 5, 1989,
- Chariot P, Perchet H, Monnet I. Dilated cardiomyopathy in HIV patients N Engl J Med 1999;340:732–5.
- Barabaro G, LorenzoG, Grisorio B, et al. Incidence of dilated cardiomyopathy and detection of HIV in myocardial cells of HIV positive patients. N Engl J Med 1998;339:1093–9
- Barbaro G. Cardiovascular manifestations of HIV infection. J R Soc Med 2001;94:384–90.827–38.
Corresponding Author
Dr T.M. Prabhu M.D.
Assistant Professor, Department of Medicine, KAPV Govt Medical College, Trichy
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.130
