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G387 Spectrum of Cardiac manifestations in HIV infected children in India
  1. A Hemal,
  2. P Singh,
  3. S Agrawal,
  4. D Yadav
  1. Paediatrics, PGIMER, Dr. RML Hospital, N Delhi, India

Abstract

Background HIV/AIDS is an important cause of morbidity and mortality affecting 2 million children less than 15 Years of age. The incidence of cardiovascular abnormalities in HIV infected children is not well documented in Indian subcontinent. Literature review shows that subclinical cardiac abnormalities in HIV infected children are common and progressive. With the introduction of HAART, the incidence is increasing due to better survival and drug related cardiotoxicity. The aim of this study was to determine the occurrence of heart disease in HIV infected children and to describe the spectrum of heart disease using non-invasive tests like ECG and Echocardiography.

Methods A cross sectional observational study was carried out on 100 HIV infected children between 1–18 years. Children with pre-existing congenital or acquired heart disease were excluded from the study. 12 lead ECG was assessed for arrhythmia, ventricular tachycardia, ST and T wave changes and heart blocks. Baseline measures of cardiac function were recorded on 2 D Echo and colour Doppler which included left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV) and left ventricular systolic function. All statistical analysis was performed using SPSS 18.0. P values of < 0.05 were considered to be statistically significant.

Results 74% of patients were male. The mean age of the patients was 9.62+3.62 years. 77% were in WHO stage I. 65% did not have significant immune suppression. 86% children were on HAART (mean duration- 35.12+29.48 months). Majority (97%) of patients were on stavudine based regimen. Clinically only 9 (9%) patients were suspected to have heart disease. After echocardiography, the prevalence of heart diseases in our study was 53%. Most common echocardiographic abnormality was left ventricular systolic dysfunction (37%) followed by abnormal left ventricular mass (29%), diastolic dysfunction (10%), pericardial effusion (2%), dilated cardiomyopathy (2%). 64.2% cases with LVSD were in WHO stage III.

Conclusions Most of the cardiac abnormalities were asymptomatic or subclinical. Early diagnosis of these abnormalities by echocardiography can help to prevent morbidity and mortality in HIV infected children.

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