TY  - JOUR
AU  - Menanga, Alain Patrick
AU  - Ngomseu, Christelle Kougang
AU  - Jingi, Ahmadou M.
AU  - Mfangam, Brigitte BrigitteMoluMfangam
AU  - Noubiap, Jean Jacques N.
AU  - Gweth, Marie Ntep
AU  - Blackett, Kathleen Ngu
AU  - Kingue, Samuel
PY  - 2015
TI  - Patterns of cardiovascular disease in a group of HIV-infected adults in Yaoundé, Cameroon
JF  - Cardiovascular Diagnosis and Therapy; Vol 5, No 6 (December 01, 2015): Cardiovascular Diagnosis and Therapy
Y2  - 2015
KW  - 
N2  -  Background:  Cardiovascular disease is an increasingly important issue in human immunodeficiency viral (HIV)-infected individuals. There is dearth of information on the patterns of cardiovascular disease especially in sub-Saharan Africa (SSA) patients. This study reports on the clinical, biological, electrocardiographic and echocardiographic characteristics of a group of HIV-infected patients presenting with symptoms of heart disease in Yaoundé, Cameroon.   Methods:  This was a cross-sectional study conducted at the Yaoundé Central Hospital and Jamot Hospital. Consenting HIV-infected adults aged ≥18 years with symptoms suggestive of heart disease were consecutively recruited between February and July 2014. All participants underwent a complete clinical examination; biological analyses including CD4 cell counts, fasting blood glucose, and serum lipids, resting electrocardiography and cardiac ultrasound, and a venous ultrasound where necessary.   Results:  Forty four subjects (21 men) were included. Their mean age was 48 (SD 13) years. Thirty patients (68.2%) were in WHO clinical stages 3 and 4 of HIV infection, 27 (61.4%) had a CD4 cell count  3 , and 31 (70.5%) were on antiretroviral therapy (ART). Hypertension (43.2%, n=19) was the most frequent cardiovascular risk factor; and dyslipidemia which was found in 17 subjects (38.6%) was significantly associated with ART (48.4%  vs.  15.4%, P=0.04). Only men where smokers (23%  vs.  0%, P=0.019). Exertional dyspnea (86.4%, n=38) and cough (59.1%, n=26) were the most frequent symptoms, and the clinical presentation was dominated by heart failure (75%, n=33). The most frequent echocardiographic abnormalities were pericardial effusion (45.5%, n=20) and dilated cardiomyopathy (22.7%, n=10). Dilated cardiomyopathy was significantly associated with CD4 cell counts  3  (100%, P=0.003). Primary pulmonary hypertension (PH) rate was 11.4% (n=5) and all cases occurred at CD4 cell counts ≥200/mm 3  (P=0.005). The most frequent electrocardiographic abnormalities were abnormal repolarization (59%, n=26) and sinus tachycardia (56.8%, n=25).   Conclusions:   Cardiovascular risk factors such as hypertension and dyslipidemia are common in HIVinfected adults with heart disease in our milieu. Advanced HIV infection in adults is associated with a high rate of symptomatic heart disease, mostly effusive pericarditis and dilated cardiomyopathy. Primary PH occurred in less advanced HIV disease.
UR  - https://cdt.amegroups.org/article/view/7273