BACKGROUND: There is geographical overlap between areas endemic for rheumatic heart disease (RHD) and those endemic for HIV. A recent pilot study demonstrated that children living with HIV might be at less risk for RHD development; however, the sample size was too small to make definitive conclusions. Our objective was to determine the prevalence of RHD among HIV-positive children in Uganda. METHODS: We conducted a prospective, cross-sectional study of HIV-positive children (5-15 years of age) receiving care at the Baylor Uganda HIV Clinic, Kampala, Uganda. A focused echocardiogram and chart review was performed. A sample size of 988 children was needed to provide 80% power to detect a difference in population prevalence between HIV-positive children and the general population, 2.97% [95% confidence interval (CI): 2.70-3.24%], based on previous reports. RESULTS: Screening echocardiography of 993 HIV-positive children found 15 individuals (1.5%; 95% CI: 0.88%-2.54%) with RHD. Of these 15, 2 were classified as definite RHD and 13 as borderline RHD. The majority of children had isolated mitral valve disease (93%). Children found to have RHD were older than those without RHD, 12 versus 10 years of age (P = 0.004). When separated based on geographic location, the prevalence of RHD among HIV-positive children from Kampala was 1.28% (95% CI: 0.63%-2.51%) compared with 2.1% (95% CI: 0.89%-4.89%) in those from outside Kampala. CONCLUSIONS: Children living with HIV have a lower prevalence of RHD than the general pediatric population. Further studies are needed to explore this protective association.
BACKGROUND: There is geographical overlap between areas endemic for rheumatic heart disease (RHD) and those endemic for HIV. A recent pilot study demonstrated that children living with HIV might be at less risk for RHD development; however, the sample size was too small to make definitive conclusions. Our objective was to determine the prevalence of RHD among HIV-positive children in Uganda. METHODS: We conducted a prospective, cross-sectional study of HIV-positive children (5-15 years of age) receiving care at the Baylor Uganda HIV Clinic, Kampala, Uganda. A focused echocardiogram and chart review was performed. A sample size of 988 children was needed to provide 80% power to detect a difference in population prevalence between HIV-positive children and the general population, 2.97% [95% confidence interval (CI): 2.70-3.24%], based on previous reports. RESULTS: Screening echocardiography of 993 HIV-positive children found 15 individuals (1.5%; 95% CI: 0.88%-2.54%) with RHD. Of these 15, 2 were classified as definite RHD and 13 as borderline RHD. The majority of children had isolated mitral valve disease (93%). Children found to have RHD were older than those without RHD, 12 versus 10 years of age (P = 0.004). When separated based on geographic location, the prevalence of RHD among HIV-positive children from Kampala was 1.28% (95% CI: 0.63%-2.51%) compared with 2.1% (95% CI: 0.89%-4.89%) in those from outside Kampala. CONCLUSIONS:Children living with HIV have a lower prevalence of RHD than the general pediatric population. Further studies are needed to explore this protective association.
Authors: Kathryn Roberts; Graeme Maguire; Alex Brown; David Atkinson; Bo Reményi; Gavin Wheaton; Andrew Kelly; Raman K Kumar; Jiunn-Yih Su; Jonathan R Carapetis Journal: Circulation Date: 2014-03-12 Impact factor: 29.690
Authors: Asha C Bowen; Rachael A Lilliebridge; Steven Y C Tong; Robert W Baird; Peter Ward; Malcolm I McDonald; Bart J Currie; Jonathan R Carapetis Journal: J Clin Microbiol Date: 2012-10-10 Impact factor: 5.948
Authors: Risa M Hoffman; Florence Chibwana; Ben Allan Banda; Daniel Kahn; Khumbo Gama; Zachary P Boas; Mayamiko Chimombo; Chiulemu Kussen; Judith S Currier; Dan Namarika; Joep van Oosterhout; Sam Phiri; Agnes Moses; Jesse W Currier; Hitler Sigauke; Corrina Moucheraud; Tim Canan Journal: Open Heart Date: 2022-05
Authors: Joselyn Rwebembera; Bruno Ramos Nascimento; Neema W Minja; Sarah de Loizaga; Twalib Aliku; Luiza Pereira Afonso Dos Santos; Bruno Fernandes Galdino; Luiza Silame Corte; Vicente Rezende Silva; Andrew Young Chang; Walderez Ornelas Dutra; Maria Carmo Pereira Nunes; Andrea Zawacki Beaton Journal: Pathogens Date: 2022-01-28