Cardiovascular manifestations of People Newly Diagnosed HIV/AIDS and their Correlation with CD4 Count: Report from Northern India

Introduction: About 21.17 lakhs people in India and about 0.49 lakh people in Punjab are living with HIV according to National AIDS Control Organization Annual Report (2015-16). Cardiovascular complications of HIV infection tend to occur late in the disease and are therefore becoming more prevalent in our society as therapy and longevity improve. Aims of this Study: To study incidence of cardiovascular morbidity in newly diagnosed HIV/AIDS patients and their correlation with CD4 count. To study the types of cardiovascular morbidities in newly diagnosed HIV /AIDS patients and their correlation with CD4 count. Methods: 100 HIV patients newly diagnosed by ELISA technique were selected for the study. All patients were subjected to cardiovascular investigations like ECG, ECHO using Philips iE33 Ultrasound Machine with X-MATRIX Technology with X5-1, supports 3D,2D colour flow, M-mode, Pulsed Wave/Continuous Wave (PW/CW) Doppler, Tissue Doppler imaging and chest x-ray. Results: Majority of the patients were asymptomatic (84%). Commonest being Chest pain(1%). 7% patients had ECG abnormalities. Commonest being sinus tachycardia (4), one patient had atrial fibrillation and 2 had LVH.Two patients had Cardiomegaly on X ray examination while remaining 98 patients had normal cardiac size. Out of the 100 patients studied, 27% patients had cardiac involvement on Echocardiography / Colour Doppler study. Out of these 27 patients, 22(80.65%) had CD4 count less than 200, 4(12.90%) had CD4 count between 201-350 and 1(6.45%) had CD4 count>350.Diastolic Dysfunction was most common abnormality followed by tricuspid regurgitation and systolic dysfunction and pericardial effusion on echocardiography / colour Doppler study. 20 patients had Diastolic Dysfunction, out of which 19 had Grade 1 diastolic dysfunction and 1 had Grade 2 diastolic dysfunction. Grade 3 and Grade 4 diastolic dysfunction was not seen in any patient. All patients with Diastolic Dysfunction had CD4 counts less than 200.Six patients had Mild Systolic Dysfunction, out of them 4 were males and 2 were females, all the males had an EF=50%, while females had EF of 50% and 52% respectively. 4 patients had CD4 count less than 200, 1 had CD4 count between 201-350 and remaining 1 CD4 count more than 350.Two patients had Pericardial Effusion and their CD4 count was less than 200. Conclusion: The commonest cardiac abnormality being detected diastolic dysfunction and least common being pericardial effusion. Diastolic dysfunction is directly related to CD4 count.