Patterns of cardiovascular risk and disease in HIV-positive adults on anti-retroviral therapy in Mozambique
| Autor: | N. Majid, I. Zimba, Ana Olga Mocumbi, Beatriz Manuel, I Dobe, N. Manafe |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Heart disease HIV Infections Comorbidity Disease Overweight Risk Assessment Young Adult Risk Factors Internal medicine Diabetes mellitus medicine Humans Prospective Studies Mozambique Aged Duration of Therapy business.industry Tuberculous pericarditis Dilated cardiomyopathy General Medicine Middle Aged medicine.disease Cross-Sectional Studies Treatment Outcome Anti-Retroviral Agents Cardiovascular Diseases Cohort Female medicine.symptom Cardiology and Cardiovascular Medicine business Viral load |
| Zdroj: | Cardiovascular Journal of Africa. 31:28-33 |
| ISSN: | 1680-0745 1995-1892 |
| DOI: | 10.5830/cvja-2020-007 |
| Popis: | Introduction With improved access to anti-retroviral therapy (ART) the focus of HIV treatment is changing to reducing chronic co-morbidities and their effects, but guidelines for HIV care in many African countries do not include screening for cardiac disease. Our study aimed to determine the pattern of cardiac abnormalities in HIV-positive patients on ART. Methods We implemented a prospective, observational study for 24 months on a random sample of adult patients seen at a dedicated HIV clinic in Mozambique. Demographic, clinical and full cardiovascular evaluations were performed on all participants. Results We enrolled 264 HIVvpositive patients (mean age 39.3 years; 186 female, 70.5%). The mean time on ART was 46 (SD 36) months and most had low viral load (174, 65%). Obesity (45, 17%), overweight (65, 24.6%), hypertension (54, 20.5%) and severe anaemia (21, 8.3%) were frequent. Diabetes was present in four patients (1.5%). The most important conditions in 252 patients submitted to echocardiography (88, 34.9% had cardiac abnormalities) were: severe rheumatic heart valve disease (six), severe dilated cardiomyopathy (five), aortic degenerative disease and congenital heart disease (in three patients each). At 24-month follow up, six of the 252 patients had died; of the 196 reviewed on echocardiography 29 had progressed and two had improved ventricular systolic function. Conclusion This young cohort of HIV-positive patients on ART showed lower occurrence of tuberculous pericarditis and dilated cardiomyopathy but high cardiovascular risk, as assessed by the presence of obesity, hypertension and anaemia. Cardiac abnormalities needing multidisciplinary care were also found. There is a need for tailored cardiovascular risk stratification and screening for cardiovascular disease in HIV-positive patients on ART in Africa. |
| Databáze: | OpenAIRE |
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