Abstract:
Objectives Diastolic dysfunction (DD) has been reported
to be highly prevalent in people living with HIV (PLWH)
on antiretroviral therapy (ART) leading to the hypothesis
that it may be an early marker of myocardial disease. Our
objective was to evaluate the prevalence of DD in people
living with human immunodeficiency virus without known
history of diabetes or hypertension in Western Kenya.
Methods In this cross-sectional study in western
Kenya, 110 PLWH on ART and without known diabetes
or hypertension were matched for age ±5 years and sex
to HIV-uninfected controls. Study participants underwent
a comprehensive two-dimensional echocardiogram and
laboratory testing.
Results The mean (SD) age in the HIV-positive group
was 42.9 (8.6) years compared with 42.1 (12.9) years in
the HIV-uninfected group. Mean (SD) CD4 +T cell count
for the HIV-positive group was 557 (220) cells/ml. Mean
systolic and diastolic blood pressures were within the
normal range and comparable between the two groups.
Mean body mass index was 25.2 (5.4) kg/m2
and 26.3
(5.4) kg/m2
in HIV-positive and uninfected participants,
respectively. There was only 1 (0.9 %) case of DD in each
group. Despite low prevalence of DD, PLWH had 5.76
g/m2
higher left ventricular mass index (p=0.01) and
2.77mL/m2
larger left atrial volume (p=0.02) compared
with the HIV-negative group after adjusting for risk factors
associated with DD.
Conclusion Contrary to prior reports, DD in PLWH was
low. Environmental and cardiovascular disease risk factors
such as diabetes and hypertension may be significant
modifiers for development and progression of DD in PLWH
