O086 Does HIV infection modify the risk of RHD? Initial echocardiographic screening experience at the Joint Clinical Research Centre in Kampala, Uganda

Introduction: The prevalence of rheumatic heart disease (RHD) is estimated tobe 10-fold higher in developing than indevelopednations; however, accurate epidemiological data is limited by the lack of echocardiography to detect subclinical RHD. Because of the immunologic basis of RHD, there is reason to suspect that HIV/AIDS may affect the prevalence and/or severity of RHD. Objectives: To describe the prevalence of subclinical RHD among HIV-infected children in Kampala, Uganda and to compare our findings with previously published and unpublished studies from Uganda. Methods: This was a cross-sectional study of HIV-infected children enrolled in care at the Joint Clinical Research Centre in Kampala. Screening echocardiograms were performed by two physician-sonographers trained in RHD screening using 2012 World Heart Federation criteria. All children with abnormal screening echocardiograms were referred for a confirmatory echocardiogram at the Uganda Heart Institute. Clinical information including age, gender, CD4 count, and use of antiretroviral therapy was obtained by chart review. Results: Screening echocardiograms were performed on 266 children (see Table). Thirteen children(4.9%) had a positive screen for definite or borderline RHD of the mitral valve and none was positive for aortic valve disease. The overall prevalence of 4.9% (definite and borderline RHD) is higher than the published prevalence of 1.5% (definite, probable, or possible RHD) among 5,000 similarly aged Kamapla school children, and higher than the 0.7% prevalence (definiteonly) inapreviousunpublished studyof 285HIV-infected childrenonART inKampala.