Cardiac dysfunction among HIV infected children on combination antiretroviral therapy attending joint clinical research centre, Kampala, Uganda.

Abstract

Introduction Human Immunodeficiency virus still remains a global problem. Cardiac dysfunction is highly prevalent among symptomatic ART naïve HIV infected children with advanced disease. Earlier studies have described left ventricular dysfunction as the most common cardiac abnormality in HIV infected children. Cardiac dysfunction has not been well described in children on combination antiretroviral therapy (cART) in Sub Saharan Africa. Therefore, the aim of this study was to determine the prevalence, types and factors associated with cardiac dysfunction among HIV infected children on combination antiretroviral therapy at JCRC, Kampala Uganda. Methods This was a cross sectional prospective descriptive study that was carried out at the Joint Clinical Research Centre in Kampala from June 2012 to January 2013. HIV infected children aged 1 to 18 years who were on combination antiretroviral therapy for at least 6 months were consecutively selected. Institutional, Informed consent and assent were obtained. Electrocardiogram and echocardiogram were performed on each study participant. Data was entered into Epidata 3.1 and analyzed by STATA version 12.0. Factors associated with cardiac dysfunction were determined using logistic regression. Results: Two hundred eighty five children were enrolled in the study. 54% were females, 46% males, and median age was 9years (IQR 6, 13); 72% were on first line cART. The mean CD4 count was 1092 cell/mm3, median viral load: 20 copies/ml (IQR 20,76). 94% had good dherence to cART. The prevalence of cardiac dysfunction among HIV infected children on cART was 28.7%.