Cardiac Dysfunction Among Ugandan HIV-Infected Children on Antiretroviral Therapy
Identifieur interne : 001D23 ( Pmc/Corpus ); précédent : 001D22; suivant : 001D24Cardiac Dysfunction Among Ugandan HIV-Infected Children on Antiretroviral Therapy
Auteurs : Judith Namuyonga ; Sulaiman Lubega ; Victor Musiime ; Peter Lwabi ; Irene LubegaSource :
- The Pediatric infectious disease journal [ 0891-3668 ] ; 2016.
Abstract
Despite effective antiretroviral therapy (ART), HIV-infected children on treatment have been observed to have cardiac abnormalities. We sought to determine the prevalence, types and factors associated with cardiac abnormalities among HIV-infected Ugandan children on combination ART.
We carried out a cross-sectional study from July 2012 to January 2013, at Joint Clinical Research Centre among HIV infected children aged 1 to 18 years. Cardiac abnormalities were assessed using electrocardiography (EKG) and echocardiography. CD4 counts, viral load and complete blood count were performed at enrollment. The prevalence of cardiac abnormalities was determined using simple proportions with the associated factors ascertained using logistic regression.
Among 285 children recruited, the median (IQR) age was 9 (6, 13) years, 54% were female; 72% were on first line cART. Their mean (±sd) CD4 count was 1092 (±868.7) cells/mm3; median (IQR) viral load was 20 (20, 76) copies/ml. 94% had adherence to ART of more than 95%. Cardiac abnormalities were detected in 39 (13.7%) children. The most common abnormalities by EKG and echocardiography were non specific T-wave changes (4.6%) and pericardial disease (thickened pericardium with or without pericardial effusion) (2.8%), respectively. No factor assessed was found to be significantly associated occurrence of cardiac dysfunction.
The prevalence of cardiac dysfunction among the HIV-infected children on ART was 13.7 % which was high, with non specific T wave changes and pericardial disease being the most frequent abnormalities observed. No factor assessed was found to be associated with cardiac dysfunction.
Url:
DOI: 10.1097/INF.0000000000000997
PubMed: 26569195
PubMed Central: 4752406
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PMC:4752406Le document en format XML
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<author><name sortKey="Namuyonga, Judith" sort="Namuyonga, Judith" uniqKey="Namuyonga J" first="Judith" last="Namuyonga">Judith Namuyonga</name>
<affiliation><nlm:aff id="A1">Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff>
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<affiliation><nlm:aff id="A2">Uganda Heart Institute, Mulago Hospital, Kampala, Uganda</nlm:aff>
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<author><name sortKey="Lubega, Sulaiman" sort="Lubega, Sulaiman" uniqKey="Lubega S" first="Sulaiman" last="Lubega">Sulaiman Lubega</name>
<affiliation><nlm:aff id="A1">Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff>
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<affiliation><nlm:aff id="A2">Uganda Heart Institute, Mulago Hospital, Kampala, Uganda</nlm:aff>
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<author><name sortKey="Musiime, Victor" sort="Musiime, Victor" uniqKey="Musiime V" first="Victor" last="Musiime">Victor Musiime</name>
<affiliation><nlm:aff id="A1">Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff>
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<affiliation><nlm:aff id="A3">Joint Clinical Research Centre (JCRC), Kampala, Uganda</nlm:aff>
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<author><name sortKey="Lwabi, Peter" sort="Lwabi, Peter" uniqKey="Lwabi P" first="Peter" last="Lwabi">Peter Lwabi</name>
<affiliation><nlm:aff id="A1">Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff>
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<author><name sortKey="Lubega, Irene" sort="Lubega, Irene" uniqKey="Lubega I" first="Irene" last="Lubega">Irene Lubega</name>
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<affiliation><nlm:aff id="A4">Makerere University-John Hopkins University (MUJHU) Care Limited, Kampala, Uganda</nlm:aff>
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<author><name sortKey="Lubega, Sulaiman" sort="Lubega, Sulaiman" uniqKey="Lubega S" first="Sulaiman" last="Lubega">Sulaiman Lubega</name>
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<affiliation><nlm:aff id="A2">Uganda Heart Institute, Mulago Hospital, Kampala, Uganda</nlm:aff>
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<author><name sortKey="Musiime, Victor" sort="Musiime, Victor" uniqKey="Musiime V" first="Victor" last="Musiime">Victor Musiime</name>
<affiliation><nlm:aff id="A1">Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff>
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<affiliation><nlm:aff id="A3">Joint Clinical Research Centre (JCRC), Kampala, Uganda</nlm:aff>
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<author><name sortKey="Lwabi, Peter" sort="Lwabi, Peter" uniqKey="Lwabi P" first="Peter" last="Lwabi">Peter Lwabi</name>
<affiliation><nlm:aff id="A1">Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff>
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<author><name sortKey="Lubega, Irene" sort="Lubega, Irene" uniqKey="Lubega I" first="Irene" last="Lubega">Irene Lubega</name>
<affiliation><nlm:aff id="A1">Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff>
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<series><title level="j">The Pediatric infectious disease journal</title>
<idno type="ISSN">0891-3668</idno>
<idno type="eISSN">1532-0987</idno>
<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Despite effective antiretroviral therapy (ART), HIV-infected children on treatment have been observed to have cardiac abnormalities. We sought to determine the prevalence, types and factors associated with cardiac abnormalities among HIV-infected Ugandan children on combination ART.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We carried out a cross-sectional study from July 2012 to January 2013, at Joint Clinical Research Centre among HIV infected children aged 1 to 18 years. Cardiac abnormalities were assessed using electrocardiography (EKG) and echocardiography. CD4 counts, viral load and complete blood count were performed at enrollment. The prevalence of cardiac abnormalities was determined using simple proportions with the associated factors ascertained using logistic regression.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Among 285 children recruited, the median (IQR) age was 9 (6, 13) years, 54% were female; 72% were on first line cART. Their mean (±sd) CD4 count was 1092 (±868.7) cells/mm<sup>3</sup>
; median (IQR) viral load was 20 (20, 76) copies/ml. 94% had adherence to ART of more than 95%. Cardiac abnormalities were detected in 39 (13.7%) children. The most common abnormalities by EKG and echocardiography were non specific T-wave changes (4.6%) and pericardial disease (thickened pericardium with or without pericardial effusion) (2.8%), respectively. No factor assessed was found to be significantly associated occurrence of cardiac dysfunction.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">The prevalence of cardiac dysfunction among the HIV-infected children on ART was 13.7 % which was high, with non specific T wave changes and pericardial disease being the most frequent abnormalities observed. No factor assessed was found to be associated with cardiac dysfunction.</p>
</sec>
</div>
</front>
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<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8701858</journal-id>
<journal-id journal-id-type="pubmed-jr-id">6404</journal-id>
<journal-id journal-id-type="nlm-ta">Pediatr Infect Dis J</journal-id>
<journal-id journal-id-type="iso-abbrev">Pediatr. Infect. Dis. J.</journal-id>
<journal-title-group><journal-title>The Pediatric infectious disease journal</journal-title>
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<issn pub-type="ppub">0891-3668</issn>
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<article-id pub-id-type="manuscript">NIHMS737340</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Cardiac Dysfunction Among Ugandan HIV-Infected Children on Antiretroviral Therapy</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Namuyonga</surname>
<given-names>Judith</given-names>
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<xref ref-type="aff" rid="A1">1</xref>
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<contrib contrib-type="author"><name><surname>Lubega</surname>
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<contrib contrib-type="author"><name><surname>Musiime</surname>
<given-names>Victor</given-names>
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<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
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<contrib contrib-type="author"><name><surname>Lwabi</surname>
<given-names>Peter</given-names>
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<given-names>Irene</given-names>
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<aff id="A1"><label>1</label>
Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda</aff>
<aff id="A2"><label>2</label>
Uganda Heart Institute, Mulago Hospital, Kampala, Uganda</aff>
<aff id="A3"><label>3</label>
Joint Clinical Research Centre (JCRC), Kampala, Uganda</aff>
<aff id="A4"><label>4</label>
Makerere University-John Hopkins University (MUJHU) Care Limited, Kampala, Uganda</aff>
<author-notes><corresp id="FN1">Corresponding author: Judith Namuyonga, Uganda Heart Institute, Mulago Hospital, P.O. Box 7051 Kampala, Tel: 256 772 580881, Fax: 256 414 532591, <email>jnamuyonga@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>21</day>
<month>11</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><month>3</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>3</month>
<year>2017</year>
</pub-date>
<volume>35</volume>
<issue>3</issue>
<fpage>e85</fpage>
<lpage>e88</lpage>
<pmc-comment>elocation-id from pubmed: 10.1097/INF.0000000000000997</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Despite effective antiretroviral therapy (ART), HIV-infected children on treatment have been observed to have cardiac abnormalities. We sought to determine the prevalence, types and factors associated with cardiac abnormalities among HIV-infected Ugandan children on combination ART.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We carried out a cross-sectional study from July 2012 to January 2013, at Joint Clinical Research Centre among HIV infected children aged 1 to 18 years. Cardiac abnormalities were assessed using electrocardiography (EKG) and echocardiography. CD4 counts, viral load and complete blood count were performed at enrollment. The prevalence of cardiac abnormalities was determined using simple proportions with the associated factors ascertained using logistic regression.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Among 285 children recruited, the median (IQR) age was 9 (6, 13) years, 54% were female; 72% were on first line cART. Their mean (±sd) CD4 count was 1092 (±868.7) cells/mm<sup>3</sup>
; median (IQR) viral load was 20 (20, 76) copies/ml. 94% had adherence to ART of more than 95%. Cardiac abnormalities were detected in 39 (13.7%) children. The most common abnormalities by EKG and echocardiography were non specific T-wave changes (4.6%) and pericardial disease (thickened pericardium with or without pericardial effusion) (2.8%), respectively. No factor assessed was found to be significantly associated occurrence of cardiac dysfunction.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">The prevalence of cardiac dysfunction among the HIV-infected children on ART was 13.7 % which was high, with non specific T wave changes and pericardial disease being the most frequent abnormalities observed. No factor assessed was found to be associated with cardiac dysfunction.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV</kwd>
<kwd>Africa</kwd>
<kwd>children</kwd>
<kwd>cardiac dysfunction</kwd>
<kwd>antiretroviral therapy</kwd>
</kwd-group>
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</front>
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