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Befkadu Z, Ibrahim M, Tadelle A, Tegene E. Electrocardiographic abnormalities and associated factors among HIV-infected adults on antiretroviral therapy. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1387464. [PMID: 39318857 PMCID: PMC11420139 DOI: 10.3389/frph.2024.1387464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 08/29/2024] [Indexed: 09/26/2024] Open
Abstract
Background Individuals living with HIV are at increased risk of developing cardiovascular diseases. This heightened vulnerability is influenced by various factors, including the direct impact of HIV infection, the side effects of HIV medications, and a higher presence of traditional cardiovascular risk factors. Detecting and managing cardiovascular diseases early in HIV-infected individuals is crucial for their overall health and well-being. Electrocardiography, a simple and non-invasive test, can provide valuable information in this regard. However, there is currently no published data on the prevalence of electrocardiographic abnormalities and the associated factors among HIV-infected adults in Ethiopia. Objectives This study was aimed at assessing the prevalence of ECG abnormalities and associated factors among HIV-infected adults on antiretroviral therapy. Methodology A hospital-based comparative cross-sectional study was conducted at Mettu Karl Specialized Hospital (MKSH), southwest Ethiopia, among 96 HIV-infected patients and 96 HIV-negative control groups. A systematic random sampling technique was used to select HIV-infected respondents, and HIV-negative respondents were purposively recruited from caregivers. A face-to-face interview with a semi-structured and pretested questionnaire was conducted to collect the socio-demographic and behavioral characteristics of the study participants. Electrocardiography was done for all study participants using a 12-lead electrocardiograph, interpreted by a cardiologist, and classified according to the Minnesota Code classification system. The data were entered into Epi-Data version 4.6 and exported to SPSS version 25 for analysis. Finally, descriptive statistics, chi-square, independent t-test, bivariable, and multivariable logistic regression analyses were done at a 5% significance level. Results The study found that 49% of HIV-infected and 19.8% of HIV-negative participants had at least one ECG abnormality. The proportion of coded ST-segment abnormalities, T-wave abnormalities, longer QT interval, and sinus tachycardia was significantly higher in HIV-infected respondents than in HIV-negatives. Being a smoker [AOR = 3.7, 95%CI: 1.03-13.6], being on Protease inhibitors [AOR = 3.6, 95%CI: 1.02-13.1] and having CD4 less than 350 cells/mm3 [AOR = 3.2, 95%CI: 1.22-8.49] were significantly associated with ECG abnormalities among HIV-infected respondents. Conclusion Compared to HIV-negative participants, HIV-infected patients had a significantly higher prevalence of ECG abnormalities. Screening for ECG abnormalities is needed for the early detection of cardiac abnormalities and the reduction of future complications.
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Affiliation(s)
- Zewudu Befkadu
- Department of Biomedical Science, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Mohammed Ibrahim
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Amanuel Tadelle
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Elsah Tegene
- Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Ethiopia
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Lumngwena EN, Mokaila D, Aremu O, Katoto PDMC, Blackburn J, Zilla P, Wiysonge CS, Ntusi N. Prevalence and Impact of HIV Infections in Patients with Rheumatic Heart Disease: A Systematic Review and Meta-Analysis. Glob Heart 2023; 18:49. [PMID: 37720311 PMCID: PMC10503531 DOI: 10.5334/gh.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 08/22/2023] [Indexed: 09/19/2023] Open
Abstract
Socioeconomic factors such as poor health and poor nutrition in low- and middle-income countries (LMICs) may favour inflammatory reactions, thus contributing to the recurrence of rheumatic fever (RF) and thereby modifying trends in rheumatic heart disease (RHD). Apart from epidemiological studies, studies of HIV infections in RHD patients are limited. This systematic review synthesises data on the prevalence and impact of HIV infections or AIDS on RHD from PubMed, Scopus, Web of Science databases up to April 2021. The outcomes were managed using PRISMA guidelines. Of a total of 15 studies found, 10 were eligible for meta-analyses. Meta-analysis found that 17% (95 % CI 8-33, I2 = 91%) of adults in cardiovascular disease (CVD) cohorts in Southern Africa are HIV positive. The proportion of RHD diagnosed among people living with HIV was 4% (95% CI 2-8, I2 = 79%) for adults but lower [2% (95% CI 1-4, I2 = 87%)] among perinatally infected children. Despite limited reporting, HIV-infected patients with RHD are prone to other infections that may enhance cardiac complications due to poor immunological control. PROSPERO registration number: CRD42021237046.
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Affiliation(s)
- Evelyn N. Lumngwena
- School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, ZA
- Centre for the Study of Emerging and Re-emerging Infections (CREMER), Institute for Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, CM
| | - Dipolelo Mokaila
- Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
| | - Olukayode Aremu
- Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
| | - Patrick DMC Katoto
- Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7501, Cape Town, ZA
- Centre for Tropical Diseases and Global Health, Catholic University of Bukavu, Democratic Republic of Congo
| | - Jonathan Blackburn
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Department of Integrative Biomedical Sciences, University of Cape Town, ZA
| | - Peter Zilla
- Christiaan Barnard Division of Cardiothoracic Surgery, University of Cape Town, ZA
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7501, Cape Town, ZA
- World Health Organization Regional Office for Africa, Citédu Djoué, Brazzaville, CG
| | - Ntobeko Ntusi
- Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Cape Universities Body Imaging Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, ZA
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Semulimi AW, Kyazze AP, Kyalo E, Mukisa J, Batte C, Bongomin F, Ssinabulya I, Kirenga BJ, Okello E. Review of electrocardiographic abnormalities among people living with HIV in Sub-Saharan Africa: A systematic review. PLoS One 2023; 18:e0283419. [PMID: 36952493 PMCID: PMC10035850 DOI: 10.1371/journal.pone.0283419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/09/2023] [Indexed: 03/25/2023] Open
Abstract
INTRODUCTION Electrocardiographic (ECG) abnormalities are increasingly being reported among people living with HIV (PLWH). However, the exact prevalence of ECG abnormalities among PLWH in Sub-Saharan Africa (SSA), a region with one of the highest burdens of HIV, is not known. Through a systematic review, we determined the prevalence and patterns of ECG abnormalities among PLWH in SSA. METHODS We conducted a search in online databases including EMBASE, MEDLINE, CINAHL and Research for Life for studies published between 1st January 2000 and 31st December 2020. Studies reporting any form of ECG abnormalities published in English were screened and reviewed for eligibility. Retrieved studies were assessed for validity using the modified Newcastle-Ottawa Scale. Data was summarized qualitatively, and ECG abnormalities were further subcategorized into rate, conduction, and rhythm abnormalities as well as atrial and ventricular enlargements. RESULTS We retrieved seventeen of the 219 studies assessed for eligibility published between 2001 and 2020, with a total of 2,572 eligible participants. The mean age of the participants ranged between 6.8 years and 58.6 years. Of the 17 studies, 8 (47%) were case-control, 6 (35.3%) cross-sectional and 3 (17.6%) were cohort in design. Thirteen studies were conducted in the adult population while four were conducted in the pediatric population. The prevalence of ECG abnormalities ranged from 10% to 81% and 6.7% to 26.5% in the adult and pediatric population respectively. Among studies done in the adult population, conduction abnormalities were the most reported (9 studies) with a prevalence ranging from 3.4% to 53.5%. In the pediatric population, rate abnormalities were the most reported (4 studies) with a prevalence ranging from 3.9% to 20.9%. The heterogeneity in results could be attributed to the absence of uniform criteria to define ECG abnormalities. CONCLUSION Our findings highlight a high prevalence of ECG abnormalities among PLWH in SSA. Consideration of ECG in the comprehensive evaluation of cardiac dysfunction among PLWH in SSA maybe warranted.
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Affiliation(s)
- Andrew Weil Semulimi
- Department of Medicine, Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Andrew Peter Kyazze
- Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Edward Kyalo
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - John Mukisa
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Charles Batte
- Department of Medicine, Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Felix Bongomin
- Faculty of Medicine, Department of Medical Microbiology & Immunology, Gulu University, Gulu, Uganda
| | - Isaac Ssinabulya
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Division of Adult Cardiology, Uganda Heart Institute, Kampala, Uganda
| | - Bruce J Kirenga
- Department of Medicine, Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Emmy Okello
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Division of Adult Cardiology, Uganda Heart Institute, Kampala, Uganda
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Woldeyes E, Fisseha H, Mulatu HA, Ephrem A, Benti H, Alem MW, Ahmed AI. Echocardiographic findings and associated factors in HIV-infected patients at a tertiary hospital in Ethiopia. Medicine (Baltimore) 2022; 101:e30081. [PMID: 35984157 PMCID: PMC9387985 DOI: 10.1097/md.0000000000030081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Noncommunicable diseases including cardiovascular diseases are becoming an important part of human immunodeficiency virus (HIV) care. Echocardiography is a useful noninvasive tool to assess cardiac disease and different echocardiographic abnormalities have been seen previously. The aim of this study was to investigate the echocardiographic abnormalities in HIV-infected patients and factors associated with the findings. A cross-sectional study was conducted on 285 patients with HIV infection including collection of clinical and echocardiographic data. Logistic regression was used to examine the association between echocardiographic abnormalities and associated factors with variables with a P value of <.05 in the multivariate model considered statistically significant. Diastolic dysfunction was the most common abnormality seen in 30% of the participants followed by ischemic heart disease (19.3%), left ventricular hypertrophy (10.2%), enlarged left atrium (8.1%), pulmonary hypertension (3.6%), and pericardial effusion (2.1%). Diastolic dysfunction was independently associated with increasing age, elevated blood pressure, and left ventricular hypertrophy while ischemic heart disease was associated with male gender, increasing age, and abnormal fasting blood glucose. Left ventricular hypertrophy was associated with increasing age and blood pressure and the later was associated with left atrial enlargement. The level of immunosuppression did not affect echocardiography findings. A high prevalence of echocardiographic abnormalities was found. Male gender, age >50 years, elevated blood pressure, and elevated fasting blood glucose were associated with echocardiographic abnormalities. Appropriate follow-up and treatment of echocardiographic abnormalities is needed.
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Affiliation(s)
- Esubalew Woldeyes
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Henok Fisseha
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- *Correspondence: Henok Fisseha, Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Swaziland Street, 1000 Addis Ababa, Ethiopia (e-mail: )
| | - Hailu Abera Mulatu
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Abiy Ephrem
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Henok Benti
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mehari Wale Alem
- Department of Neurosurgery, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Wu X, Manickam S, Wu T, Pang CH. Insights into the Role of Graphene/Graphene‐hybrid Nanocomposites in Antiviral Therapy. CHEMBIOENG REVIEWS 2021. [DOI: 10.1002/cben.202100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Xinyun Wu
- University of Nottingham Ningbo China Department of Chemical and Environmental Engineering 315100 Ningbo China
| | - Sivakumar Manickam
- University of Technology Brunei Department of Petroleum and Chemical Engineering BE1410 Bandar Seri Begawan Brunei Darussalam
| | - Tao Wu
- University of Nottingham Ningbo China Key Laboratory for Carbonaceous Wastes Processing and Process Intensification Research of Zhejiang Province 315100 Ningbo China
- University of Nottingham Ningbo China New Materials Institute 315100 Ningbo China
| | - Cheng Heng Pang
- University of Nottingham Ningbo China Department of Chemical and Environmental Engineering 315100 Ningbo China
- University of Nottingham Ningbo China Municipal Key Laboratory of Clean Energy Conversion Technologies 315100 Ningbo China
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