Key result
HIV infection is linked to significantly higher prevalence and severity of CMR-detected myocardial fibrosis.
Why the study?
Observational studies using cardiac magnetic resonance have explored the relationship between HIV infection and myocardial fibrosis, but scarcity of data synthesis limits understanding.
Does HIV infection increase the prevalence and severity of myocardial fibrosis assessed by cardiac magnetic resonance imaging in adults?
Meta-Analysis (n=1,769)
Does HIV infection increase the prevalence and severity of myocardial fibrosis assessed by cardiac magnetic resonance imaging in adults?
p-value: p=< 0.001
HIV infection is associated with a significantly higher prevalence and severity of myocardial fibrosis on cardiac MRI, highlighting a potential mechanism for increased cardiovascular risk in this population.
May inform enhanced CV risk stratification in HIV; reinforces meta-analytic evidence of increased myocardial fibrosis on CMR.
Introduction: Human immunodeficiency virus (HIV) infection is linked to myocardial fibrosis. Observational studies using cardiac magnetic resonance (CMR) have explored this relationship but scarcity of data synthesis limits our understanding. Our systematic review and meta-analysis aimed to synthesize associations between HIV and myocardial fibrosis from CMR-based observational studies in adults. Methods: We identified 12 studies (2013-2024) with 1,769 participants [1,117 people with HIV (PWH)]. Three studies were cohort and nine were cross-sectional. Meta-analysis included seven studies on late gadolinium enhancement (LGE) (1,081 participants: 669 PWH), eight on native T1 mapping (840 participants: 467 PWH), and ten on ECVF (1,603 participants: 992 PWH). We examined myocardial fibrosis prevalence via the prevalence difference in LGE, and severity by mean differences in native T1 mapping values [milliseconds (ms)] and global extracellular volume fraction (ECVF,%) between PWH and HIV-uninfected individuals, using random effects model. Results and discussion: < 0.001), respectively. Meta-regression showed no significant associations between ECVF and demographic, HIV-related, or cardiac factors. LGE and native T1 mapping analyses lacked sufficient data for meta-regression. In conclusion, PWH exhibit significantly higher prevalence and severity of myocardial fibrosis compared to HIV-uninfected individuals. But standardized methodologies and further research are essential to enhance consistency. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=533379, CRD [42024533379].
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Mutengo et al. (2025) conducted a meta-analysis in HIV infection (n=1,769). HIV infection vs. HIV-uninfected individuals was evaluated on Myocardial fibrosis prevalence (LGE) and severity (native T1 mapping and ECVF) (p=< 0.001). People with HIV exhibit significantly higher prevalence and severity of myocardial fibrosis on cardiac magnetic resonance imaging compared to HIV-uninfected individuals.
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