Patterns of Arrythmias among HIV infected Patients on Highly Active Antiretroviral Therapy (HAART) and its Relationship with CD4 Cells Count and Viral load in a Tertiary Hospital in North Eastern Nigeria
DOI:
https://doi.org/10.60787/tnhj.v24i3.836Keywords:
Arrhythmia, HIV, Highly Active Antiretroviral Therapy, CD4 cells count, viral loadAbstract
Background: Human immunodeficiency virus (HIV) pandemic continues to be a major public health problem globally. The advent of highly active antiretroviral therapy has changed the natural history of HIV as well as the morbidity and mortality associated with the disease. However, patients living with HIV infection remain at increased risk of cardiovascular diseases and sudden cardiac death. Diverse electrocardiographic abnormalities were reported among HIV infected patients. However, to the best of our knowledge, there are few studies on patterns of arrhythmias among HIV infected patients in northeastern part of Nigeria.
Method: It was a cross-sectional study conducted among HIV infected patients receiving highly active anti-retroviral therapy (HAART) at the Federal Medical Centre Nguru, Yobe State, North Eastern Nigeria.
Result: One hundred (100) subjects were recruited into the study comprising thirty-three (33.0%) males and 67(67.0%) females. The mean CD4 cells count and viral load of the studied patients were 614.99 ± 34.92 cells/μL and 4654±58.79 copies/mL, respectively. The commonest cardiac rhythm was sinus rhythm, followed by sinus tachycardia and atrial fibrillation. Other abnormalities observed includes: First degree atrioventricular block, nonspecific intraventricular conduction defect, right bundle branch block, left bundle branch block and left posterior hemi block.
Conclusion: In conclusion, the study revealed that premature ventricular contractions both (unifocal and multifocal) are the commonest cardiac arrhythmias, while sinus tachycardia and non-specific intraventricular conduction defect are the second common cardiac arrhythmias, the study further revealed that low CD4 cells count and high viral load were found to be associated with diverse cardiac arrhythmias.
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Onovo AA, Adeyemi A, Onime D, Kalnoky M, Kagniniwa B, Dessie M, et`al. Estimation of HIV prevalence and burden in Nigeria: a Bayesian predictive modelling study. eClinical Medicine 2023;62: 102098. https://doi.org/10. 1016/j.eclinm.2023. 102098.
Sterne JA, Hernan MA, Ledergerber B, Tilling K, Weber R, Sendi P, et al. Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study. Lancet 2005; 366:378–384.
Hemkens LG, Bucher HC. HIV infection and cardiovascular disease. Eur Heart J 2014; 35:1373–1381
Sani MU, Okeahialam BN. QTc interval prolongation in patients with HIV and AIDS. J Natl Med Assoc. 2005;97(12):1657-1661.
Attamah CA, Sadoh WE, Ibadin MO, OmoigberaleAI. Electrocardiographic findings in human immunodeficiency virus-infected children in Benin City, Nigeria. Niger Postgrad Med J 2020; 27:357-64
Orunta CP, Ibeneme CA, Ogbonna IF, Ukaegbu U, Otaigbe BE. Electrocardiographic abnormalities in children with human immunodeficiency virus infection presenting to the federal medical centre, Umuahia, South-east Nigeria. Niger J Med 2023; 32:375-81
PO Njoku, EC Ejim, BC Anisiuba, SO Ike, BJC Onwubere. Electrocardiographic findings in a cross-sectional study of human immunodeficiency virus (HIV) patients in Enugu, south-east Nigeria. Cardiovascular journal of Africa 2016;27(4):252-257
Sanders JM, Steverson AB, Pawlowski AE, Schneider D, Achenbach CJ, LloydJone DM, et al. Atrial fibrillation (AF) and atrial flutter (AFL) prevalence and characteristics for persons with human immunodeficiency virus (HIV+) and matched uninfected controls. PLoS One 2018; 20:13.
Das MK. Cardiac arrhythmias in HIV disease. Cardiovasc Rev Rep 2002; 23:208- 212.
Okoye CI, Anyabolu NE. Electrocardiographic abnormalities in treatment-naïve HIV subjects in south-east Nigeria. Cardiovascular Journal of Africa 2017;28(5):315- 318
Schneider E, Whitmore S, Glynn K, Dominguez K, Mitsch A, Mckenna MT. (2008). Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged < 18 months and for HIV infection and AIDS among children aged 18 months to < 13 years—United States, 2008. MMWR, 57(RR-10): 1–12. Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5710.pdf. (date accessed 4th September,2024)
The role of HIV viral suppression in improving individual health and reducing transmission. WHO Team, Global HIV, Hepatitis and STIs Programmes (HHS). WHO Policy Brief 22 July 22023;16 ISBN: 978-92-4-005517-9. https://www.who.int/publications/i/item/9789240055179 (accessed 4th September,2024)
Perazella MA, Brown E. Electrolyte and acid-base disorders associated with AIDS: an etiologic review. J Gen Intern Med 1994; 9(4): 232-236
Kooij KW, Vogt L, Wit FWNM, van der Valk M, van Zoest RA, Goorhuis A, et’ al. AGE HIV Cohort Study. Higher prevalence and faster progression of chronic kidney disease in human immunodeficiency virus-infected middle-aged individuals compared with human immunodeficiency virus uninfected controls. J Infect Dis. 2017;216(6):622-631.
Sullivan PS, Hanson DL, Chu SY, Jones JL and Ward JW. Epidemiology of anaemia in human immunodeficiency virus (HIV)-infected persons: Results from the multistate adult and adolescent spectrum of HIV disease surveillance project. Blood. 1998; 91:301-308.
Ding Y, Zhu B, Lin H, Chen X, Shen W, Xu X, et`al. HIV infection and electrocardiographic abnormalities: baseline assessment from the CHART cohort, Clinical Microbiology and Infection, https://doi.org/10.1016/j.cmi.2020.03.005
Hsu JC, Li Y, Marcus GM, Hsue PY, Scherzer R, Grunfeld C, et al. Atrial fibrillation and atrial flutter in human immunodeficiency virus-infected persons: incidence, risk factors, and association with markers of HIV disease severity. J Am Coll Cardiol. 2013; 61(22):2288-2295.
Currie PF, Boon NA. Immunopathogenesis of HIV-related heart muscle disease: current perspectives. AIDS 2003; 17(Suppl 1): S21–S28
Baba MM, Buba F, Talle MA, Umar H, Garbati MA and Abdul H. Assessment of probability of pulmonary arterial hypertension among HIV-1 infected patients on HAART and its relationship with Cd4 cells Count and viral load. Kanem J Med Sci 2021; 15(2): 124 – 131
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