Skip to main content
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 2002 Nov;78(925):678–681. doi: 10.1136/pmj.78.925.678

Cardiac involvement in HIV infected people in Yaounde, Cameroon

D Nzuobontane 1, K Blackett 1, C Kuaban 1
PMCID: PMC1742549  PMID: 12496326

Abstract

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/mm32 = 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.

Full Text

The Full Text of this article is available as a PDF (100.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barbaro G. Cardiovascular manifestations of HIV infection. J R Soc Med. 2001 Aug;94(8):384–390. doi: 10.1177/014107680109400804. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Barbaro G., Di Lorenzo G., Grisorio B., Barbarini G. Incidence of dilated cardiomyopathy and detection of HIV in myocardial cells of HIV-positive patients. Gruppo Italiano per lo Studio Cardiologico dei Pazienti Affetti da AIDS. N Engl J Med. 1998 Oct 15;339(16):1093–1099. doi: 10.1056/NEJM199810153391601. [DOI] [PubMed] [Google Scholar]
  3. Behrens G., Schmidt H., Meyer D., Stoll M., Schmidt R. E. Vascular complications associated with use of HIV protease inhibitors. Lancet. 1998 Jun 27;351(9120):1958–1958. doi: 10.1016/S0140-6736(98)26026-0. [DOI] [PubMed] [Google Scholar]
  4. Carr A., Cooper D. A. Adverse effects of antiretroviral therapy. Lancet. 2000 Oct 21;356(9239):1423–1430. doi: 10.1016/S0140-6736(00)02854-3. [DOI] [PubMed] [Google Scholar]
  5. Cegielski J. P., Ramiya K., Lallinger G. J., Mtulia I. A., Mbaga I. M. Pericardial disease and human immunodeficiency virus in Dar es Salaam, Tanzania. Lancet. 1990 Jan 27;335(8683):209–212. doi: 10.1016/0140-6736(90)90288-g. [DOI] [PubMed] [Google Scholar]
  6. Chariot P., Perchet H., Monnet I. Dilated cardiomyopathy in HIV-infected patients. N Engl J Med. 1999 Mar 4;340(9):732–735. doi: 10.1056/NEJM199903043400911. [DOI] [PubMed] [Google Scholar]
  7. Currie P. F., Jacob A. J., Foreman A. R., Elton R. A., Brettle R. P., Boon N. A. Heart muscle disease related to HIV infection: prognostic implications. BMJ. 1994 Dec 17;309(6969):1605–1607. doi: 10.1136/bmj.309.6969.1605. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Domanski M. J., Sloas M. M., Follmann D. A., Scalise P. P., 3rd, Tucker E. E., Egan D., Pizzo P. A. Effect of zidovudine and didanosine treatment on heart function in children infected with human immunodeficiency virus. J Pediatr. 1995 Jul;127(1):137–146. doi: 10.1016/s0022-3476(95)70275-x. [DOI] [PubMed] [Google Scholar]
  9. Eisenberg M. J., Gordon A. S., Schiller N. B. HIV-associated pericardial effusions. Chest. 1992 Sep;102(3):956–958. doi: 10.1378/chest.102.3.956. [DOI] [PubMed] [Google Scholar]
  10. Flynn T. E., Bricker L. A. Myocardial infarction in HIV-infected men receiving protease inhibitors. Ann Intern Med. 1999 Oct 5;131(7):548–548. doi: 10.7326/0003-4819-131-7-199910050-00032. [DOI] [PubMed] [Google Scholar]
  11. Heidenreich P. A., Eisenberg M. J., Kee L. L., Somelofski C. A., Hollander H., Schiller N. B., Cheitlin M. D. Pericardial effusion in AIDS. Incidence and survival. Circulation. 1995 Dec 1;92(11):3229–3234. doi: 10.1161/01.cir.92.11.3229. [DOI] [PubMed] [Google Scholar]
  12. Henry K., Melroe H., Huebsch J., Hermundson J., Levine C., Swensen L., Daley J. Severe premature coronary artery disease with protease inhibitors. Lancet. 1998 May 2;351(9112):1328–1328. doi: 10.1016/S0140-6736(05)79053-X. [DOI] [PubMed] [Google Scholar]
  13. Herskowitz A., Vlahov D., Willoughby S., Chaisson R. E., Schulman S. P., Neumann D. A., Baughman K. L. Prevalence and incidence of left ventricular dysfunction in patients with human immunodeficiency virus infection. Am J Cardiol. 1993 Apr 15;71(11):955–958. doi: 10.1016/0002-9149(93)90913-w. [DOI] [PubMed] [Google Scholar]
  14. Herskowitz A., Willoughby S. B., Baughman K. L., Schulman S. P., Bartlett J. D. Cardiomyopathy associated with antiretroviral therapy in patients with HIV infection: a report of six cases. Ann Intern Med. 1992 Feb 15;116(4):311–313. doi: 10.7326/0003-4819-116-4-311. [DOI] [PubMed] [Google Scholar]
  15. Himelman R. B., Chung W. S., Chernoff D. N., Schiller N. B., Hollander H. Cardiac manifestations of human immunodeficiency virus infection: a two-dimensional echocardiographic study. J Am Coll Cardiol. 1989 Apr;13(5):1030–1036. doi: 10.1016/0735-1097(89)90256-8. [DOI] [PubMed] [Google Scholar]
  16. Lipshultz S. E. Dilated cardiomyopathy in HIV-infected patients. N Engl J Med. 1998 Oct 15;339(16):1153–1155. doi: 10.1056/NEJM199810153391609. [DOI] [PubMed] [Google Scholar]
  17. Lipshultz S. E., Easley K. A., Orav E. J., Kaplan S., Starc T. J., Bricker J. T., Lai W. W., Moodie D. S., Sopko G., Colan S. D. Cardiac dysfunction and mortality in HIV-infected children: The Prospective P2C2 HIV Multicenter Study. Pediatric Pulmonary and Cardiac Complications of Vertically Transmitted HIV Infection (P2C2 HIV) Study Group. Circulation. 2000 Sep 26;102(13):1542–1548. doi: 10.1161/01.cir.102.13.1542. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Longo-Mbenza B., Seghers L. V., Vita E. K., Tonduangu K., Bayekula M. Assessment of ventricular diastolic function in AIDS patients from Congo: a Doppler echocardiographic study. Heart. 1998 Aug;80(2):184–189. doi: 10.1136/hrt.80.2.184. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Longo-Mbenza B., Tonduangu K., Seghers K. V., Mubagwa D. Irruption de l'infection par le VIH et des pèricardites en Afrique. Arch Mal Coeur Vaiss. 1997 Oct;90(10):1377–1384. [PubMed] [Google Scholar]
  20. Milei J., Grana D., Fernández Alonso G., Matturri L. Cardiac involvement in acquired immunodeficiency syndrome--a review to push action. The Committee for the Study of Cardiac Involvement in AIDS. Clin Cardiol. 1998 Jul;21(7):465–472. doi: 10.1002/clc.4960210704. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Moreno R., Villacastín J. P., Bueno H., López de Sá E., López-Sendón J. L., Bobadilla J. F., García-Fernández M. A., Delcán J. L. Clinical and echocardiographic findings in HIV patients with pericardial effusion. Cardiology. 1997 Sep-Oct;88(5):397–400. doi: 10.1159/000177367. [DOI] [PubMed] [Google Scholar]
  22. Silva-Cardoso J., Moura B., Martins L., Mota-Miranda A., Rocha-Gonçalves F., Lecour H. Pericardial involvement in human immunodeficiency virus infection. Chest. 1999 Feb;115(2):418–422. doi: 10.1378/chest.115.2.418. [DOI] [PubMed] [Google Scholar]
  23. Sullivan A. K., Nelson M. R., Moyle G. J., Newell A. M., Feher M. D., Gazzard B. G. Coronary artery disease occurring with protease inhibitor therapy. Int J STD AIDS. 1998 Nov;9(11):711–712. doi: 10.1258/0956462981921251. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES