Left ventricular hypertrophy in African children infected with HIV/AIDS: a case-control study.

INTRODUCTION

left ventricular hypertrophy (LVH) measured by echocardiography seen in human immunodeficiency virus/acquired immunodeficiency disease (HIV/AIDS) affects the morbidity and mortality. The hemodynamic and metabolic changes in (HIV/AIDS) affect the heart adversely causing hypertrophic remodeling with left ventricular hypertrophy. The aim of this study was to determine the prevalence and risk factors associated with LVH in African children with HIV/AIDS.

METHODS

an analytical case-control study was conducted using echocardiography to assess cardiac function. Descriptive statistics was used to determine percentages and univariate analysis to find association between dependent variable and independent variables. Independent variables that had an association in a univariate were included in the multivariate model to determine strength of association.

RESULTS

the mean age of the study population was 7.8 ± 2.07 years for controls and 8.3 ± 3.04 years for cases respectively. They were made up of 51.2% (n= 86) males and 48.8% (n = 82) females (M: F=1.05: 1). We studied eighty-four (n= 84) cases, and LVH was seen in 67.7% (n= 56) of the patients. Mean left ventricular mass index (g/m2) was significantly higher in the cases (90.37± 35.50) than controls (89.37 ± 14.25, p= 0.04.) Relative wall thickness (mm) was within normal in the control, 0.35 ± 0.06 and high in the cases, 0.67 ± 0.17, p= 0.01. Eccentric hypertrophy was the most common type seen in 36.9% (n= 31) of the patients. Multiple linear regression analysis, revealed that the presence of LVH was associated with 0.212 (95% CI: 0.001 - 0.014; p= 0.001) lower Body mass index (BMI) for age and 0.396 (95% CI; 0.002 - 0.066; p= 0.03) lower CD4+ cell count as predictors of LVH.

CONCLUSION

the prevalence of LVH was high. Lower body mass index (BMI) and CD4+cells count predicted LVH. This supports the recommendation by the National Heart, Lung and Blood Institute (NHLBI) working group on research priorities for cardiovascular complications in HIV/AIDS, for baseline and periodic echocardiography in the management of children with HIV/AIDS.