Study of profile of cardiac dysfunction in HIV infected children

Background: There are very few published studies of heart disease in HIV infected children. The incidence of cardiovascular disease reported among HIV infected children ranges from 72% to 90%. Cardiac disease was primary cause of death in 25% of HIV Positive patients. Studies carried out in Indian subcontinent have demonstrated the presence of systolic and diastolic dysfunction on 2D Echo in HIV infected patients. Objectives: To determine the prevalence, and describe the type of heart disease among children with HIV attending an ART centre in Gandhi hospital and centre of excellence Niloufer hospital in collaboration Department of Cardiology, Gandhi Hospital. Materials and methods: 100 HIV infected children in age group of 1-18 years attending an ART centre in Gandhi hospital and centre of excellence Niloufer hospital from December 2011 to August 2013 were evaluated clinically, and investigated by chest X-ray, electrocardiography and 2D-echo.
 Results: Heart abnormalities were detected in 48 children (43 by 2D-echo, 4 by ECG, 1 by chest X-ray). The abnormalities included left ventricular systolic dysfunction (16%), left ventricular dilation (8%), left ventricular hypertrophy (11%), Pulmonary artery hypertension (11%), tricuspid regurgitation (14%) pulmonary regurgitation (4%), mitral regurgitation (4%), sinus tachycardia (4%), cardiomegaly on chest X-ray 1 of total 100 children taken for study. Conclusions: Heart abnormalities were common especially in HIV infected children. Clinical examination, chest radiograph and ECG may pick up manifest cardiac disease. Sub-clinical manifestations such as left ventricular dilatation hypertrophy and decrease systolic dysfunction can be detected only by echo cardiography. Annual echography and ECG examination is recommended to evaluate the progression of cardiac disease and treat the same before it become irreversible in HIV infected children.