Cardiovascular diseases in HIV infected children and adolescents on highly anti-retroviral therapy at the university of Abuja teaching hospital, Gwagwalada, Nigeria

Background: Effect of prolong use of antiretroviral therapy and chronic HIV infection on cardiac performance of infected children and adolescents requires evaluation. We studied cardiac structure/functions, and troponin levels of these subjects on anti-retroviral therapy for > 6 months in our hospital.  Methods: A cross sectional survey was conducted in our facility for the above objectives. Bio-data, time and type antiretroviral drugs, mode of transmission, weight, height, body-mass-index, echocardiogram, electrocardiogram, CD4, viral load, and troponin were done for all subjects. Results: Of a total of 126 subjects recruited, 66 (52.4%) were males. Their mean age, and duration on antiretroviral therapy was 14.1±3.1 (7, 18) years, and 7.2±2.9 (1, 14) years. Majority 69 (54.8%) were between 15-18 years, most 73 (57.9%) had BMI of <18 kg/m2, and 99 (78.6%) had vertical transmition. Their mean troponin-1 level was 2.0±1.6ng/ml. Abnormal echocardiogram and electrocardiogrm was detected in 41.3% and 38.1% of the subjects, with mild-systolic-dysfunction (11.9%), pulmonary-hypertension (11.1%) and left-ventricular-dysfunction (10.3%) as the commonest abnormal echocardiogram findings, and sinus-tachycardia 16 (12.7%), non-specific-ST-T abnormality 12 (9.5%), mild-right and left-ventricular-hypertrophy 4 (3.2%) as the commonest electrocardiogram abnormalities detected. Significant relationship was seen between troponin and the following variables; echocardiogram, chi2 36.95, p=0.0001; electrocardiogram, chi2 59.07, p=0.0001; body-mass-index chi2 13.63, p=0.001; 1st line antiretroviral therapy, chi2 21.187, p=0.001, 2nd line, chi2 19.978, p=0.002; CD4, chi2 6.896, p=0.032; and viral-load, chi2 7.515, p=0.023.  Conclusions: There is high prevalence of cardiac abnormalities among the study subjects. Echocardiogram and electrocardiogram to be included in their baseline and follow-up care for early disease detection, and initiation of measures to halt its progression.