Key result
HIV-infected children had a higher prevalence of myocardial injury than controls (48% vs 8%, p<0.001), and serum cTnI demonstrated 91.3% sensitivity and 88.9% specificity as a diagnostic marker.
Why the study?
Studies have shown elevation of cardiac Troponin I in HIV-infected subjects, but most studies were conducted in adults.
Does serum Cardiac Troponin I serve as a reliable diagnostic marker of myocardial injury in HIV-infected children?
Cross-Sectional (n=200)
No
Does serum Cardiac Troponin I serve as a reliable diagnostic marker of myocardial injury in HIV-infected children?
Absolute Event Rate: 48% vs 8%
p-value: p=<0.001
Serum cTnI is a reliable marker of myocardial injury, which has a high prevalence (48%) among HIV-infected children.
cTnI may aid detection of myocardial injury in HIV-infected children; hypothesis-generating and requires prospective validation before clinical adoption.
Background: Cardiac Troponin I (cTnI) is a unique marker of myocardial injury. It is the most sensitive and specific of the cardiac markers. Studies have shown its elevation among Human Immunodeficiency Virus (HIV) infected subjects. Most of these were in adults hence we determined the use of cTnI as a marker of myocardial injury among HIV subjects. Methods: The study was a comparative cross-sectional study among 100 HIV - infected children aged 2 – 14 years and equal age-matched HIV-uninfected controls. Recruitment was through the Paediatric HIV and outpatient clinics of the hospital respectively. Both groups had serum cTnI assay (normal is <0.1μ/L) over four months period. Data analysis was done using the SPSS® v 20. Normally distributed data had mean standard deviation while not normally distributed data had a median with an interquartile range determined. The diagnostic performance of cTnI was determined using the Receiver Operating Characteristics curve. Significant p is < 0.05. Results: A total of 200 (subjects and controls) were studied. The mean age of participants was 9.42 years. There was a significant difference in the median (IQR) cTnI of HIV-infected subjects [73.8 (51.8 – 149.1)] compared with HIV uninfected controls [25.0 (13.3 – 51.4)] p < 0.001. The prevalence of myocardial injury among subjects was 48% compared with 8% among controls, also statistically significant (p < 0.001). Serum cTnI has 91.3% and 88.9% sensitivity and specificity respectively. Conclusions: The prevalence of myocardial injury was high in HIV - infected children. Serum cTnI is a reliable predictive marker of myocardial injury.
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Bello et al. (2023) conducted a cross-sectional in HIV infection (n=200). HIV infection vs. HIV-uninfected controls was evaluated on Prevalence of myocardial injury (p=<0.001). HIV-infected children had a higher prevalence of myocardial injury than controls (48% vs 8%, p<0.001), and serum cTnI demonstrated 91.3% sensitivity and 88.9% specificity as a diagnostic marker.
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