A Study of Cardiovascular Manifestations in HIV Positive Patients and Their Association with the CD4 Cell Count

BACKGROUNDCardiovascular diseases in HIV positive patients are being increasingly detected in the developing countries and is likely to become even more prevalent as HIV infected individuals live longer.It is found that prevalence of cardiovascular disease is high in people with lower CD4 cell counts.The present study is therefore undertaken to identify the cardiovascular involvement in HIV and its relation with CD4 cell count. METHODSA cross sectional observational study was conducted in a tertiary care hospital, from 2015 to 2017 which included 500 HIV patients.All patients were assessed clinically and underwent electrocardiogram (ECG), 2D echocardiography, CD4 cell count along with routine investigations.The presence of cardiac involvement was determined based on electrocardiogram and echocardiography findings.An attempt was made to correlate various cardiac finding with CD4 cell count. RESULTSOne third of study population (34 %) was found to have cardiovascular manifestations.Chest radiograph revealed cardiomegaly in 66 out of 170 patients.ECG abnormalities were found in 72.94 % while the most common echo findings were fractional shortening of < 30 % found in 44.1 % of the patients.These echocardiographic abnormalities are more in patients with CD4 count less than 50 / μL.Majority (54.12 %) of the study population had a CD4 cell count of less than 50 / μL. CONCLUSIONSIn the present study, one third of HIV infected patients had cardiovascular manifestations.The most common clinical cardiac diagnosis in patients with HIV infection was heart failure followed by pulmonary hypertension.Reduced fractional shortening followed by reduced ejection fraction were the most common echocardiographic findings.Patients with low CD4 count have increased cardiovascular manifestations.