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© Journal of Xiangya Medicine. All rights reserved. J Xiangya Med 2018;3:14 jxym.amegroups.com
Introduction
Sub-Saharan Africa is home to over 65% of the global
paediatric HIV burden (1). As the HIV pandemic matures,
more HIV-infected children are surviving into and beyond
adolescence because of increasing access to highly active
antiretroviral therapy (HAART). With this increasing
survival, there is increasing reports of chronic diseases
involving cardiopulmonary, neurologic, musculoskeletal
and metabolic systems (2-4). Cardiovascular complications
of HIV are one of the most commonly reported chronic
complications of HIV (5-8).
HIV-infected children are at increased risk of
chronic cardiac conditions owing to cumulative lifelong
exposure of the myocardium to both the HIV virus,
opportunistic pathogens and ARVs particularly during early
developmental stages (7-10). Several mechanisms have been
proposed for the deleterious effect of the virus on the heart,
including direct viral invasion of the myocardium, chronic
inflammation, endothelial dysfunction, autoimmunity,
Cardiac size and systolic function of HIV-infected Lagos children
accessing routine care: a pilot study
Barakat Adeola Animasahun, Ijeoma Nnena Diaku-Akinwumi, Peter Odion Ubuane, Edith Ibitoye
Department of Paediatrics and Child Health, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Lagos, Nigeria
Contributions: (I) Conception and design: BA Animasahun; (II) Administrative support: BA Animasahun, E Ibitoye; (III) Provision of study materials
or patients: BA Animasahun, IN Diaku-Akinwumi; (IV) Collection and assembly of data: BA Animasahun, PO Ubuane; (V) Data analysis and
interpretation: PO Ubuane, BA Animasahun; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
Correspondence to: Barakat Adeola Animasahun. Department of Paediatrics and Child Health, Lagos State University College of Medicine/Lagos State
University Teaching Hospital, Ikeja, Lagos, Nigeria. Email: deoladebo@yahoo.com.
Background: Previous studies have reported high, though declining, prevalence of HIV-associated cardiac
dysfunction globally. However, there is relative paucity of data on the prevalence and pattern of HIV-
associated cardiac disorders in Nigerian children. The index study aimed to conduct a pilot evaluation of the
frequency and pattern of cardiac dysfunctions in HIV-infected children in a tertiary health facility in Lagos,
Nigeria.
Methods: Thirty-nine HIV-infected children, with 41 age- and sex-matched controls, were prospectively
recruited in a cross-sectional study. Subjects had echocardiography to obtain measures of cardiac dimensions
and function. Subjects’ anthropometry, blood pressure and clinical profle were also obtained.
Results: HIV-infected children had signifcantly thicker interventricular septal diameter (IVSD) (P=0.0018)
and larger left atrial diameter (P=0.003) and aortic root diameter (P=0.023); other parameters (right
ventricular diameter, left ventricular diameter, left ventricular posterior wall diameter, left ventricular mass
(LVM), ejection fraction, fractional shortening) were similar between both groups. There was no signifcant
difference in the prevalence of LVH between those on zidovudine-based regimen compared to those on non-
zidovudine-based regimen (P=0.703).
Conclusions: The prevalence of subclinical echocardiographic abnormalities was high and was more in
those below fve years of age. In a setting of limited resources, this age group may be prioritized for serial
monitoring of cardiac abnormalities.
Keywords: Cardiac dysfunction; children; Nigeria; HIV/AIDS; echocardiography
Received: 31 January 2018; Accepted: 22 March 2018; Published: 20 April 2018.
doi: 10.21037/jxym.2018.03.04
View this article at: http://dx.doi.org/10.21037/jxym.2018.03.04
Original Article