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Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa

BACKGROUND: Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiog...

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Autores principales: Roozen, Geert V. T., Meel, Ruchika, Peper, Joyce, Venter, William D. F., Barth, Roos E., Grobbee, Diederick E., Klipstein-Grobusch, Kerstin, Vos, Alinda G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853516/
https://www.ncbi.nlm.nih.gov/pubmed/33529208
http://dx.doi.org/10.1371/journal.pone.0244742
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author Roozen, Geert V. T.
Meel, Ruchika
Peper, Joyce
Venter, William D. F.
Barth, Roos E.
Grobbee, Diederick E.
Klipstein-Grobusch, Kerstin
Vos, Alinda G.
author_facet Roozen, Geert V. T.
Meel, Ruchika
Peper, Joyce
Venter, William D. F.
Barth, Roos E.
Grobbee, Diederick E.
Klipstein-Grobusch, Kerstin
Vos, Alinda G.
author_sort Roozen, Geert V. T.
collection PubMed
description BACKGROUND: Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiographic characteristics in an urban African population, comparing HIV-positive people (treated and not yet treated) with HIV-negative controls. METHODS: We conducted a cross-sectional study in Johannesburg, South Africa. We enrolled HIV-positive participants from three randomized controlled trials that had recruited participants from routine HIV testing programs. HIV-negative controls were recruited from the community. Data were collected on demographics, cardiovascular risk factors, medical history and electrocardiographic and echocardiographic characteristics. RESULTS: In total, 394 HIV-positive participants and 153 controls were enrolled. The mean age of HIV-positive participants was 40±9 years (controls: 35±10 years), and 34% were male (controls: 50%). Of HIV-positive participants 36% were overweight or obese (controls: 44%), 23% had hypertension (controls: 28%) and 12% were current smoker (controls: 37%). Median time since HIV diagnosis was 6.0 years (IQR 2.3–10.0) and median treatment duration was 4.0 years (IQR 0.0–8.0), 50% had undetectable viral load. The frequency of anatomical cardiac abnormalities was low and did not differ between people with and without HIV. We observed no relation between HIV or anti-retroviral therapy (ART) and systolic or diastolic heart function. There was an association between ART use and corrected QT interval: +11.8 ms compared to HIV-negative controls (p<0.01) and +18.9 ms compared to ART-naïve participants (p = 0.01). We also observed a higher left ventricular mass index in participants on ART (+7.8 g/m(2), p<0.01), but this association disappeared after adjusting for CD4 cell count, viral load and HIV-duration. CONCLUSION: The low number of major cardiac abnormalities in this relatively young, well managed urban African HIV-positive population is reassuring. The increase in corrected QT interval and left ventricular mass may contribute to higher cardiac mortality and morbidity in people living with HIV in the long term.
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spelling pubmed-78535162021-02-09 Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa Roozen, Geert V. T. Meel, Ruchika Peper, Joyce Venter, William D. F. Barth, Roos E. Grobbee, Diederick E. Klipstein-Grobusch, Kerstin Vos, Alinda G. PLoS One Research Article BACKGROUND: Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiographic characteristics in an urban African population, comparing HIV-positive people (treated and not yet treated) with HIV-negative controls. METHODS: We conducted a cross-sectional study in Johannesburg, South Africa. We enrolled HIV-positive participants from three randomized controlled trials that had recruited participants from routine HIV testing programs. HIV-negative controls were recruited from the community. Data were collected on demographics, cardiovascular risk factors, medical history and electrocardiographic and echocardiographic characteristics. RESULTS: In total, 394 HIV-positive participants and 153 controls were enrolled. The mean age of HIV-positive participants was 40±9 years (controls: 35±10 years), and 34% were male (controls: 50%). Of HIV-positive participants 36% were overweight or obese (controls: 44%), 23% had hypertension (controls: 28%) and 12% were current smoker (controls: 37%). Median time since HIV diagnosis was 6.0 years (IQR 2.3–10.0) and median treatment duration was 4.0 years (IQR 0.0–8.0), 50% had undetectable viral load. The frequency of anatomical cardiac abnormalities was low and did not differ between people with and without HIV. We observed no relation between HIV or anti-retroviral therapy (ART) and systolic or diastolic heart function. There was an association between ART use and corrected QT interval: +11.8 ms compared to HIV-negative controls (p<0.01) and +18.9 ms compared to ART-naïve participants (p = 0.01). We also observed a higher left ventricular mass index in participants on ART (+7.8 g/m(2), p<0.01), but this association disappeared after adjusting for CD4 cell count, viral load and HIV-duration. CONCLUSION: The low number of major cardiac abnormalities in this relatively young, well managed urban African HIV-positive population is reassuring. The increase in corrected QT interval and left ventricular mass may contribute to higher cardiac mortality and morbidity in people living with HIV in the long term. Public Library of Science 2021-02-02 /pmc/articles/PMC7853516/ /pubmed/33529208 http://dx.doi.org/10.1371/journal.pone.0244742 Text en © 2021 Roozen et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Roozen, Geert V. T.
Meel, Ruchika
Peper, Joyce
Venter, William D. F.
Barth, Roos E.
Grobbee, Diederick E.
Klipstein-Grobusch, Kerstin
Vos, Alinda G.
Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa
title Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa
title_full Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa
title_fullStr Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa
title_full_unstemmed Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa
title_short Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa
title_sort electrocardiographic and echocardiographic abnormalities in urban african people living with hiv in south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853516/
https://www.ncbi.nlm.nih.gov/pubmed/33529208
http://dx.doi.org/10.1371/journal.pone.0244742
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