Prevalence of cardiomyopathy in HIV infection: Prospective study on 158 HIV patients

Background. - There is evidence that the human immunodeficiency virus (HIV) may affect the heart and left ventricular dysfunction appears to be common. Objective. - This was the first study in Morocco to investigate the frequency of cardiomyopathy in patients infected with HIV. Methods. - We made a prospective echocardiographic study of 158 patients starting in September 2004 (88 men and 70 women, mean age 34 [5.4] years) with positive HIV serology and a clinical diagnosis of HIV infection according to CDC criteria and 80 seronegative control subjects. Patients were classified as AIDS group (90 patients) and HIV group (+) (68 patients) and HIV (-) (80 subjects). Results. - Twenty-eight out of 156 (17.7%) cases of cardiomyopathy were found, distributed in 24 out of 90 (26.6%) in the AIDS group and four out of 68 (2.8%) in the HIV + group (p < 0.01) and none in the HIV (-) group. Left ventricular diastolic dysfunction was noted among 88 out of 158 (55.7%) infected patients. There was a significant increase of cardiomyopathy in patients with HIV infection and decreased CD4 (less than 100 per millimetre cube; n = 16 [57%]) compared to those with CD4 between 100 and 200 per millimetre cube; n = 6 (21.42%) (p = 0.03). Conclusion. - Echocardiography was a useful technique for the early detection of cardiac dysfunction in asymptomatic HIV positive carriers and AIDS patients. The frequency is related to HIV infection stage and CD4+ counts. Left ventricular diastolic dysfunction can precede systolic dysfunction and may be a useful technique for the early detection of cardiac dysfunction. (c) 2008 Elsevier Masson SAS.