The prevalence and characteristics of cardiovascular disorders in children infected with human immunodeficiency virus type 1 (HIV-l) at Muhimbili National Hospital.

Abstract

Introduction and review of Literature. The prevalence and characteristics of HIV cardiac disorders vary from one area to another, and these have seldom been elucidated in African children. The cardiac disorders include disturbances of rhythm, pericardial effusions, cardiomyopathies, endocarditis, arteriopathies and other cardiac diseases. Study objective To determine the prevalence and characteristics of cardiovascular disorders in children infected with Human Immunodeficiency Virus type 1 (HIV-1). Study design A cross-sectional comparative hospital based study. Setting The study was conducted in the General Paediatric wards and General Paediatric outpatient clinics of Muhimbili National Hospital (MNH) in Dar es Salaam, from April 2001 to January 2002. Subjects A total of 280 children aged between 18 months to 7 years who were admitted in the wards or seen at outpatient clinic, were recruited for the study.

vii Methodology All children aged between 18 months to 7 years attending Paediatric outpatient clinics or admitted to MNH medical Paediatric wards whose parents/guardians consented for the study and for HN testing were enrolled for study. A thorough history and physical examination was done on recruitment. All children who tested positive for HN infection formed the study group. Children who tested negative for HN infection formed the comparable group. Both groups were further subjected to cardiovascular assessment including chest X-Ray, Electrocardiogram and Echocardiogram. Main outcome measures The main outcome measures were the magnitude and characteristics of cardiovascular disorders among the two studied groups. Results The overall prevalence of cardiovascular diso~ders was 83/280. (29.6%) The prevalence of cardiovascular disorders in HIV infected children was higher at 36/78 (46.2%) compared to 47/202 (23.3%) in HN uninfected children. The difference was statistically significant in the two studied groups, p=O.OOO 17. The common cardiac disorders strongly associated with HN-infected children were; pericardial effusion 26.9%, Left ventricular dysfunction 24.7%, cardiomyopathy 24.4% and tachycardia 20.5%. V11I Conclusions and Recommendations. 1. Cardiovascular disorders are common among HIV -1 infected children at MNH. 2. Echocardiogram was the most important tool in diagnosing cardiac disorders. 3. Cardiac disorders in HIV -1 positive children were similar to those reported in other centres.

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It is recommended that a thorough c)diovascular evaluation including Echocardiogram should be done in HIV infected children so as to diagnose cardiac disorders easily and offer better management.