Table 5 shows the pattern of cardiac diseases and gender distribution in patients with HIV/AIDS.
The prevalence of left ventricular systolic dysfunction and left ventricular diastolic dysfunction were significantly higher in male infected patients than female HIV-infected patients (31.6% vs 9.7%, p=0.006 and 50.0% vs 21.0%, p=0.003 respectively).
There was no significant difference in the prevalence of DCM in patients with left ventricular systolic dysfunction between male and female HIV-infected patients (15.8% vs 4.8%,
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p=0.063). There was no significant difference in the prevalence of hypertension in patients with left ventricular systolic dysfunction between male and female HIV-infected patients (15.8% vs 4.8%, p=0.063).
The prevalence of combined left ventricular systolic and diastolic dysfunction was not significantly different between male and female HIV-infected patients, p=0.299.
The prevalence of pericardial effusion, cardiac arrhythmias, ischaemic heart disease and valvular abnormality was not statistically different among males and females with HIV/AIDS, p=0.369, p=0.471, p=0.068 and 0.757 respectively. The two cases of isolated right ventricular dysfunction were seen in HIV-infected male patients. This however was not statistically significant when compared with the HIV-infected female patients, p=0.068. Also, the two cases of pulmonary hypertension were seen in HIV-infected male patients. This also was not statistically significant when compared with the HIV-infected female patients, p=0.068.
Table 5: Pattern of cardiac diseases and sex distribution in patients with HIV/AIDS
Variables Sex X2 P-value Male (N = 38) Female (N = 62)
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N (%) N (%)
Pericardial effusion LV systolic dysfunction DCM
Hypertension
LV Diastolic dysfunction Combined LVSDD Isolated RV Dysfunction Pulmonary HTN
Cardiac Arrhythmias IHD
Valvular abnormality
13 12 6 6 19 2 2 2 9 2 7
(34.2) (31.6) (15.8) (15.8) (50.0) (5.3) (5.3) (5.3) (23.7) (5.3) (18.4%)
16 6 3 3 13 1 0 0 11 0 13
(25.8) (9.7) (4.8) (4.8) (21.0) (1.6) (0.0) (0.0) (17.7) (0.0) (21.0)
0.808 0.369 7.657 0.006*
3.450 0.063 3.450 0.063 9.126 0.003*
1.079 0.299 3.330 0.068 3.330 0.068 0.520 0.471 3.330 0.068 0.096 0.757
Key: DCM – Dilated cardiomyopathy, LV-Left ventricular, RV – Right ventricular, HTN- Hypertension, IHD-Ischaemic Heart Disease, LVSDD-Left ventricular systolic and diastolic dysfunction.
*=statistically significant association Chi-square was used for the variables.
X2= Chi-square value
P-value ≤ 0.05 was taken as the level of statistical significance.
5.2.3 Conventional cardiovascular risk factors and age group distribution in patients with HIV/AIDS.
Table 6 shows the pattern of conventional cardiovascular risk factors and the age group among patients with HIV/AIDS.
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The prevalence of dyslipidaemia was not significantly different across the age groups of HIV-infected patients, p=0.454. The prevalence of hypertension was also not statistically different across the age groups of patients with HIV/AIDS, p=0.931.
The prevalence of smoking, abnormal fasting glucose and abnormal BMI were also not statistically different among the age groups of HIV-infected individuals (p=0.661, p=0.373 and p=0.123 respectively).
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Table 6: Pattern of cardiovascular risk factors and age group distribution in patients with HIV Variables Age groups in years X2 P-value
18-44 (N = 72) 45-64 (N = 28)
N (%) N (%)
Dyslipidemia Hypertension Smoking
Abnormal Fasting glucose Impaired fasting glucose Diabetes mellitus Abnormal BMI in Kg/m2 Underweight Overweight Obesity
15 16 8 16 15 1 15 9 5 1
(20.8) (22.2) (11.1) (22.2) (20.8) (1.4) (20.8) (12.5) (6.9) (1.4)
4 6 4 4 3 1 10 6 4 0
(14.3) (21.4) (14.3) (14.3) (10.7) (3.6) (35.7) (21.4) (14.3) (0.0)
0.562 0.454 0.007 0.931 0.192 0.661 0.794 0.373 1.399 0.237 0.490 0.484 2.381 0.123 1.261 0.262 1.327 0.249 0. 393 0.531 Key: BMI – Body mass index.
*=statistically significant association Chi-square was used for the variables.
X2= Chi-square value
P-value ≤ 0.05 was taken as the level of statistical significance.
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5.2.4 Cardiac diseases and age groups among patients with HIV/AIDS
Table 7 shows the pattern of cardiac diseases and age groups of patients with HIV/AIDS.
The prevalence of pericardial effusion was not significantly different among the age groups of patients with HIV/AIDS, p=0.953.
The prevalence of left ventricular systolic and diastolic dysfunction were higher in patients with HIV/AIDS above 44years of age, though not reaching a significant level when compared with those that ages 44years and below, p=0.086 and 0.620 respectively.
The prevalence of dilated cardiomyopathy and hypertension in patients with left ventricular systolic dysfunction were not statistically different among the age groups of patients with HIV/AIDS, p=0.709 and p=0.054 respectively.
The prevalence of combined left ventricular systolic and diastolic dysfunction was not significantly different among the age groups of patients with HIV/AIDS, p=0.835.
The prevalence of isolated right ventricular, pulmonary hypertension, cardiac arrhythmias, IHD and valvular abnormality were not statistically different among the age groups of patients with HIV/AIDS, p=0.373, p=0.373, p=0.436, p=0.484 and p=0.824 respectively.
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Table 7: Pattern of cardiac diseases and age group distribution of patients with HIV/AIDS Variables Age groups in years X2 P-value
18-44 (N = 72) 45-64 (N = 28)
N (%) N (%)
Pericardial effusion LV systolic dysfunction DCM
Hypertensive
LV Diastolic dysfunction Combined LVSDD Isolated RV Dysfunction Pulmonary HTN
Cardiac Arrhythmias IHD
Valvular abnormality
21 10 6 4 22 2 2 2 13 1 14
(29.2) (13.9) (8.3) (5.6) (30.6) (2.8) (2.8) (2.8) (18.1) (1.4) (19.4)
8 8 3 5 10 1 0 0 7 1 6
(28.6) (28.6) (10.7) (17.9) (35.7) (3.6) (0.0) (0.0) (25.0) (3.6) (21.4)
0.003 0.953 2.944 0.086 0.140 0.709 3.725 0.054 0.247 0.620 0.044 0.835 0.794 0.373 0.794 0.373 0.608 0.436 0.490 0.484 0.050 0.824
Key: DCM – Dilated cardiomyopathy, LV-Left ventricular, RV-Right ventricular, HTN – Hypertension, IHD-Ischaemic Heart Disease, LVSD – Left ventricular systolic and diastolic dysfunction
Chi-square was used for the variables.
X2= Chi-square value
P-value ≤ 0.05 was taken as the level of statistical significance.
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5.3 CONVENTIONAL CARDIOVASCULAR RISK FACTORS AND CARDIAC DISEASES AMONG HIV PATIENTS ON HAART AND THOSE NOT ON HAART.
5.3.1 Conventional cardiovascular risk factors among HIV-infected patients on HAART and those not on HAART.
Table 8 shows the relationship between the cardiovascular risk factors among patients with HIV on HAART and those not on HAART.
The prevalence of dyslipidaemia and hypertension were not statistically different among HIV-infected patients on HAART and those not on HAART, p=0.444 and p=0.334 respectively. The prevalence of smoking and abnormal fasting glucose were not statistically different among HIV-infected patients on HAART and those not on HAART (p=1.000 and p=0.317 respectively).
The prevalence of underweight was significantly higher among HIV-infected patients who were not on HAART (24.0%) compared to 6.0% for HIV-infected patients on HAART, p=0.012. There was no significant difference in the mean CD4 count of HIV-infected patients on HAART and those not on HAART, p= 0.299.
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Table 8: Pattern of cardiovascular risk factors among HIV/AIDS patients on HAART and those not on HAART
Variables HIV patients on
HAART (N = 50)
HIV patients
HAART Nạve (N = 50)
X2 P-value
N (%) N (%)
Dyslipidemia Hypertension Smoking
Abnormal Fasting
Impaired fasting glucose Diabetes mellitus Abnormal BMI in Kg/m2 Underweight
Overweight Obesity
8 9 6 12 10 2 10 3 6 1
(16.0) (18.0) (12.0) (24.0) (20.0) (4.0) (20.0) (6.0) (12.0) (2.0)
11 13 6 8 8 0 15 12 3 0
(22.0) (26.0) (12.0) (16.0) (16.0) (0.0) (30.0) (24.0) (6.0) (0.0)
0.585 0.444 0.932 0.334 0.000 1.000 1.000 0.317 0.271 0.603 2.041 0.153 1.333 0.248 6.353 0.012*
1.099 0.295 1.010 0.315
CD4 Count 456.84±277.06 400.28±264.02 t=1.045 p-0.299
Key: BMI-Body mass index, CD- Clusters of differentiation
*=statistically significant association Student t-test was used for the CD4 Count Chi-square was used for other variables.
X2= Chi-square value t= student t-test value
P-value ≤ 0.05 was taken as the level of statistical significance.
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5.3.2 Cardiac diseases among HIV patients on HAART and those not on HAART.
Table 9 shows the pattern of cardiac diseases among patients with HIV/AIDS on HAART and those not on HAART.
The prevalence of left ventricular diastolic dysfunction was significantly higher in HIV-infected patients not on HAART compared to HIV-HIV-infected patients on HAART, p=0.032.
The prevalence of pericardial effusion was not significantly different among HIV-infected patients on HAART and those not on HAART, p=0.826.
The prevalence of left ventricular systolic dysfunction was not significantly different among HIV-infected patients on HAART and those not on HAART, p=0.603. The prevalence of DCM and hypertension in those with left ventricular systolic dysfunction were not statistically different between HIV-infected patients on HAART and those not on HAART, p=0.727 and p=0.727 respectively. The prevalence of combined left ventricular systolic and diastolic dysfunction was also similar in the two groups of HIV-infected patients, p=0.558.
The two cases of isolated right ventricular were seen in HIV-infected patients on HAART, this however, was not statistically significant when compared with HIV-infected patients not on HAART, p=0.153. The prevalence of pulmonary hypertension, cardiac arrhythmias and ischaemic heart disease were not statistically different among HIV-infected patients on HAART and those not on HAART, (p=0.153, p=1.000 and p=0.153 respectively). There was
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no significant difference in the mean CD4 count of HIV-infected patients on HAART and those not on HAART, p= 0.299.
Table 9: Pattern of cardiac diseases among patients with HIV/AIDS on HAART and those not on HAART
Variables HIV patients on
HAART (N = 50)
HIV patients
HAART Nạve (N = 50)
X2 P-value
N (%) N (%)
Pericardial effusion LV systolic dysfunction DCM
Hypertension
LV Diastolic dysfunction Combined LVSDD Isolated RV Dysfunction Isolated Pulmonary HTN Cardiac Arrhythmias IHD
Valvular abnormality
14 8 4 4 11 2 2 2 10 2 9
(28.0) (16.0) (8.0) (8.0) (22.0) (4.0) (4.0) (4.0) (20.0) (4.0) (18.0)
15 10 5 5 21 1 0 0 10 0 11
(30.0) (20.0) (10.0) (10.0) (42.0) (2.0) (0.0) (0.0) (20.0) (0.0) (22.0)
0.049 0.826 0.271 0.603 0.122 0.727 0.122 0.727 4.596 0.032*
0.344 0.558 2.041 0.153 2.041 0.153 0.000 1.000 2.041 0.153 0.250 0.617
CD4 Count 456.84±277.06 400.28±264.02 t-1.045 p-0.299
Key: DCM – Dilated cardiomyopathy, LV-Left ventricular, RV-Right ventricular, HTN – Hypertension, IHD-Ischaemic Heart Disease, LVSD – Left ventricular systolic and diastolic dysfunction, CD- Clusters of
differentiation
*=statistically significant association Student t-test was used for the CD4 Count
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Chi-square was used for other variables.
X2= Chi-square value t= student t-test value
P-value ≤ 0.05 was taken as the level of statistical significance.
5.4 CONVENTIONAL CARDIOVASCULAR RISK FACTORS AND CARDIAC DISEASES AMONG HIV PATIENTS AND THE RELATIONSHIP WITH CD4 COUNT.
5.4.1 Conventional cardiovascular risk factors among HIV-infected patients and the relationship with CD4 count.
Table 10 shows the relationship between conventional cardiovascular risk factors among patients with HIV and the CD4 count categories.
The prevalence of smoking was significantly different across the CD4 count groups (p<0.001). The highest prevalence of smoking was seen HIV-infected patients with CD4 count bellow 200 cells/mm3. The prevalence of underweight was highest in HIV-infected patients with CD4 count below 200cells/mm3 (34.1%) compared to other groups of CD4 counts, p=<0.001. The prevalence of overweight was statistically significant across the CD4 count groups, being highest in those with CD4 count ≥500cells/mm,3 p<0.001.
The prevalence of hypertension, dyslipidaemia and abnormal fasting glucose were not statistically different among the groups of CD4 counts in HIV-infected patients (p=0.174, p=0.271 and p=0.234 respectively).
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Table 10: Pattern of cardiovascular risk factors and the relationship with CD4 counts in patients with HIV/AIDS
Variables CD4 count
<200cells/mm3 (N= 44)
CD4 count 200-499cells/mm3
(N= 52)
CD4 >500cells/mm3 (N= 4)
X2 P-value
N (%) N (%) N (%)
Dyslipidemia Hypertension Smoking
Abnormal Glucose
Impaired fasting glucose Diabetes mellitus Abnormal BMI in Kg/m2 Underweight
Overweight Obesity
8 7 12 12 11 1 24 15 0 0
(18.2) (15.9) (27.3) (27.3) (25.0) (2.3) (54.6) (34.1) (0.0) (0.0)
9 15 0 7 6 1 1 0 5 1
(17.3) (28.8) (0.0) (13.5) (11.5) (1.9) (1.9) (0.0) (9.6) (1.9)
2 0 0 1 1 0 0 0 4 0
(50.0) (0.0) (0.0) (25.0) (25.0) (0.0) (0.0) (0.0) (100.0) (0.0)
2.614 0.271 3.500 0.174 12.587 0.002*
2.906 0.234 3.064 0.216 0.100 0.951 36.587 <0.001*
22.460 <0.001*
44.820 <0.001*
0.932 0.627 Key: BMI – Body mass index
*=statistically significant association Chi-square was used for the variables X2= Chi-square value
P-value ≤ 0.05 was taken as the level of statistical significance.
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5.4.2 Cardiac diseases among HIV patients and the relationship with CD4 Count
Table 11 shows the pattern of cardiac diseases among patients with HIV/AIDS and CD4 count categories.
The prevalence of pericardial effusion was significantly different across the groups of CD4 count among HIV-infected patients p<0.001. The prevalence of pericardial effusion was highest in those HIV-infected patients with CD4 count below 200 cells/mm3.
The prevalence of left ventricular systolic dysfunction and left ventricular diastolic dysfunction were significantly different across the groups of CD4 count among HIV-infected patients (p<0.001 and p=0.008 respectively). The prevalence of left ventricular systolic dysfunction and left ventricular diastolic dysfunction were also highest in those HIV-infected patients with CD4 count below 200 cells/mm3. The prevalence of DCM in those with left ventricular systolic dysfunction was significantly different across the groups of CD4 counts, p=0.002, being highest in those with CD4 count below 200 cells/mm3. The prevalence of hypertension in those with left ventricular systolic dysfunction was not significantly different across the CD4 counts, p=0.098. The prevalence of cardiac arrhythmias was statistically different among the groups of CD4 counts, being highest in those with CD4 counts below 200 cells/mm3, p=0.028.
The two cases of isolated right ventricular dysfunction and pulmonary hypertension each were seen in HIV patients with CD4 counts below 200 cells/mm3, though not reaching level of statistical significance when compared to other CD4 categories (p=0.273 and p=0.273 respectively). The prevalence of ischaemic heart disease was not significantly different among the sub groups of CD4 counts, P=0.273. The prevalence of valvular abnormality was significantly different across the groups of CD4 counts, p=0.028, being highest in those with CD4 count below 200 cells/mm3
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Table 11: Pattern of cardiac diseases and the relationship with CD4 counts in patients with HIV/AIDS
Variables CD4 count
<200cells/mm3 (N= 44)
CD4 count 200-499cells/mm2
(N= 52)
CD4
>500cells/mm
3 (N= 4)
X2 P-value
N (%) N (%) N (%)
Pericardial effusion LV systolic dysfunction DCM
Hypertension
L V diastolic dysfunction Combined LVSDD Isolated RV dysfunction Pulmonary HTN
Cardiac Arrhythmias IHD
Valvular abnormality
26 16 9 7 21 3 2 2 14 2 14
(59.1) (36.4) (20.5) (15.9) (47.7) (6.8) (4.5) (4.5) (31.8) (4.5) (31.8)
2 2 0 2 11 0 0 0 6 0 6
(3.8) (3.8) (0.0) (3.8) (21.2) (0.0) (0.0) (0.0) (11.5) (0.0) (11.5)
1 0 0 0 0 0 0 0 0 0 0
(25) (0.0) (0.0) (0.0) (0) (0.0) (0.0) (0.0) (0.0) (0.0) (0.0)
35.360 <0.001*
17.989 <0.001*
12.587 0.002*
4.647 0.098 9.695 0.008*
3.936 0.140 2.597 0.273 2.597 0.273 7.168 0.028*
2.597 0.273 7.168 0.028
Key: DCM – Dilated cardiomyopathy, LV-Left ventricular, RV – Right ventricular, HTN – Hypertension, IHD-Ischaemic heart Disease, LVSDD-Left ventricular systolic and diastolic dysfunction.
*=statistically significant association Chi-square was used for the variables.
X2= Chi-square value
P-value ≤ 0.05 was taken as the level of statistical significance.
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