Original Research

Prevalence of severe cardiovascular abnormalities amongst West African HIV-infected patients on antiretroviral therapy followed at a referral HIV centre

Frederic N. Ello, Esaie K. Soya, N'douba A. Kassi, Patrick A. Coffie, Gisele A. Koaukou, Melaine C. Mossou, Doumbia Adama, Icklo Coulibaly, Eboi Ehui, Aristophane Tanon, Serge P. Eholie
Southern African Journal of Infectious Diseases | Vol 36, No 1 | a187 | DOI: https://doi.org/10.4102/sajid.v36i1.187 | © 2021 Frederic N. Ello, Esaie K. Soya, N’douba A. Kassi, Patrick A. Coffie, Gisèle A. Koaukou, Melaine C. Mossou, Doumbia Adama, Icklo Coulibaly, Eboi Ehui, Aristophane Tanon, Serge P. Eholie | This work is licensed under CC Attribution 4.0
Submitted: 16 December 2019 | Published: 16 February 2021

About the author(s)

Frederic N. Ello, Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire; and Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
Esaie K. Soya, Institut de Cardiologie d’Abidjan, Abidjan, Côte d'Ivoire
N'douba A. Kassi, Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire; and Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
Patrick A. Coffie, Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire; and Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
Gisele A. Koaukou, Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire; and Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
Melaine C. Mossou, Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire; and Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
Doumbia Adama, Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire; and Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
Icklo Coulibaly, Institut de Cardiologie d’Abidjan, Abidjan, Côte d'Ivoire
Eboi Ehui, Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire; and Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
Aristophane Tanon, Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire; and Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
Serge P. Eholie, Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire; and Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire


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Abstract

Background: With success and effective long-term antiretroviral treatment (ART), HIV-infected patients live longer and frequently developed non-communicable diseases (NCDs). Few studies have been conducted in low-income countries, particularly in West Africa.

Methods: We carried out a cross-sectional study in the referral HIV centre of the Service des Maladies Infectieuses et Tropicales (SMIT) in Abidjan. From April to September 2015, we consecutively included HIV-1 infected patients aged 18 years and older, and on ART for a minimum of 12 months. Data were collected using a structured questionnaire, and entered into the centre’s computerised HIV database. Clinical assessment, laboratory tests, electrocardiogram, transthoracic echocardiography and vascular Doppler ultrasound were performed. The main outcome was the prevalence of patients with severe cardiovascular abnormalities (SCA). Univariate and multivariate logistic regressions were used to identify factors associated with SCA.

Results: Out of 278 patients (median age 46 years, interquartile range [IQR: 41–52]), 74.5% were female. Overall, the median duration of ART was 84 months (IQR: 54–126). One hundred and ninety-nine (71.6%) patients were on first-line ART regimen and 229 (82.4%) were virologically suppressed with a median CD4 count of 511 cells/mm3 (IQR: 347–529). Basically, cardiovascular abnormalities were mainly non-obstructive carotid plaques (19.1%) followed with left ventricular diastolic dysfunction (16.5%). The overall prevalence of SCA in the study population was 7.6% (95% Confidence Interval [95% CI]: 4.7–11.3). The prevalence of SCA 7.6% (95% Confidence Interval [95% CI]: 4.7–11.3). In multivariate analysis, age > 50 years and nadir CD4 count > 200 cells/mm3 were significant predictors of SCA.

Conclusion: The prevalence of SCA is high in West African HIV-treated patients. Given the high mortality associated with cardiovascular diseases in the general population, refining disease preventive strategies in HIV-positive subjects is essential to continue prolonging their life.


Keywords

prevalence; cardiovascular disease; HIV; antiretroviral treatment; CD4 count.

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