Sebhat Erqou1, Bereket Tessema Lodebo2, Ahmad Masri3, Ahmed M Altibi4, Justin B Echouffo-Tcheugui5, Anastase Dzudie6, Feven Ataklte7, Gaurav Choudhary8, Gerald S Bloomfield9, Wen-Chih Wu10, Andre Pascal Kengne11. 1. Department of Medicine, Providence VA Medical Center, Providence, Rhode Island; Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island. Electronic address: sebhaterqou@gmail.com. 2. Department of Medicine, Harbor-UCLA Medical Center, Los Angeles, California. 3. Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: https://twitter.com/MasriAhmadMD. 4. Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 5. Department of Medicine, Johns Hopkins University, Baltimore, Maryland. 6. Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon. 7. Department of Medicine, Boston University, Boston, Massachusetts. 8. Department of Medicine, Providence VA Medical Center, Providence, Rhode Island; Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island. Electronic address: https://twitter.com/GChoudharyMD. 9. Duke Clinical Research Institute, Duke Global Health Institute and Department of Medicine, Duke University, Durham, North Carolina. 10. Department of Medicine, Providence VA Medical Center, Providence, Rhode Island; Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island. 11. South African Medical Research Council and University of Cape Town, South Africa.
Abstract
OBJECTIVE: To synthesize existing epidemiological data on cardiac dysfunction in HIV. BACKGROUND: Data on the burden and risk of human immunodeficiency virus (HIV) infection-associated cardiac dysfunction have not been adequately synthesized. We performed meta-analyses of extant literature on the frequency of several subtypes of cardiac dysfunction among people living with HIV. METHODS: We searched electronic databases and reference lists of review articles and combined the study-specific estimates using random-effects model meta-analyses. Heterogeneity was explored using subgroup analyses and meta-regressions. RESULTS: We included 63 reports from 54 studies comprising up to 125,382 adults with HIV infection and 12,655 cases of various cardiac dysfunctions. The pooled prevalence (95% confidence interval) was 12.3% (6.4% to 19.7%; 26 studies) for left ventricular systolic dysfunction (LVSD); 12.0% (7.6% to 17.2%; 17 studies) for dilated cardiomyopathy; 29.3% (22.6% to 36.5%; 20 studies) for grades I to III diastolic dysfunction; and 11.7% (8.5% to 15.3%; 11 studies) for grades II to III diastolic dysfunction. The pooled incidence and prevalence of clinical heart failure were 0.9 per 100 person-years (0.4 to 2.1 per 100 person-years; 4 studies) and 6.5% (4.4% to 9.6%; 8 studies), respectively. The combined prevalence of pulmonary hypertension and right ventricular dysfunction were 11.5% (5.5% to 19.2%; 14 studies) and 8.0% (5.2% to 11.2%; 10 studies), respectively. Significant heterogeneity was observed across studies for all the outcomes analyzed (I2 > 70%, p < 0.01), only partly explained by available study level characteristics. There was a trend for lower prevalence of LVSD in studies reporting higher antiretroviral therapy use or lower proportion of acquired immune deficiency syndrome. The prevalence of LVSD was higher in the African region. After taking into account the effect of regional variation, there was evidence of lower prevalence of LVSD in studies published more recently. CONCLUSIONS: Cardiac dysfunction is frequent in people living with HIV. Additional prospective studies are needed to better understand the burden and risk of various forms of cardiac dysfunction related to HIV and the associated mechanisms. (Cardiac dysfunction in people living with HIV-a systematic review and meta-analysis; CRD42018095374).
OBJECTIVE: To synthesize existing epidemiological data on cardiac dysfunction in HIV. BACKGROUND: Data on the burden and risk of human immunodeficiency virus (HIV) infection-associated cardiac dysfunction have not been adequately synthesized. We performed meta-analyses of extant literature on the frequency of several subtypes of cardiac dysfunction among people living with HIV. METHODS: We searched electronic databases and reference lists of review articles and combined the study-specific estimates using random-effects model meta-analyses. Heterogeneity was explored using subgroup analyses and meta-regressions. RESULTS: We included 63 reports from 54 studies comprising up to 125,382 adults with HIV infection and 12,655 cases of various cardiac dysfunctions. The pooled prevalence (95% confidence interval) was 12.3% (6.4% to 19.7%; 26 studies) for left ventricular systolic dysfunction (LVSD); 12.0% (7.6% to 17.2%; 17 studies) for dilated cardiomyopathy; 29.3% (22.6% to 36.5%; 20 studies) for grades I to III diastolic dysfunction; and 11.7% (8.5% to 15.3%; 11 studies) for grades II to III diastolic dysfunction. The pooled incidence and prevalence of clinical heart failure were 0.9 per 100 person-years (0.4 to 2.1 per 100 person-years; 4 studies) and 6.5% (4.4% to 9.6%; 8 studies), respectively. The combined prevalence of pulmonary hypertension and right ventricular dysfunction were 11.5% (5.5% to 19.2%; 14 studies) and 8.0% (5.2% to 11.2%; 10 studies), respectively. Significant heterogeneity was observed across studies for all the outcomes analyzed (I2 > 70%, p < 0.01), only partly explained by available study level characteristics. There was a trend for lower prevalence of LVSD in studies reporting higher antiretroviral therapy use or lower proportion of acquired immune deficiency syndrome. The prevalence of LVSD was higher in the African region. After taking into account the effect of regional variation, there was evidence of lower prevalence of LVSD in studies published more recently. CONCLUSIONS:Cardiac dysfunction is frequent in people living with HIV. Additional prospective studies are needed to better understand the burden and risk of various forms of cardiac dysfunction related to HIV and the associated mechanisms. (Cardiac dysfunction in people living with HIV-a systematic review and meta-analysis; CRD42018095374).
Authors: Jonathan Buggey; Leo Yun; Chung-Lieh Hung; Cissy Kityo; Grace Mirembe; Geoffrey Erem; Tiffany Truong; Isaac Ssinabulya; W H Wilson Tang; Brian D Hoit; Grace A McComsey; Chris T Longenecker Journal: Heart Date: 2019-09-19 Impact factor: 5.994
Authors: Suman Srinivasa; Teressa S Thomas; Meghan N Feldpausch; Gail K Adler; Steven K Grinspoon Journal: J Clin Endocrinol Metab Date: 2021-11-19 Impact factor: 5.958