Predictors of echocardiographic abnormalities among people living with hiv on anti-retroviral therapy in Kumasi, Ghana.

Background: Cardiac abnormalities are common among patients living with human immunodeficiency virus (PLWH) on anti-retroviral therapy (ART). Echocardiograms represent a useful modality in determining cardiac abnormalities among PLWH. In Ghana, the predictors of echocardiographic abnormalities have not been extensively elucidated. This study was designed to determine HIV-specific and traditional risk factors associated with echocardiographic abnormalities among PLWH on ART.

Methods: One-hundred and seventeen (117) PLWH attending the HIV clinic at the Komfo Anokey Teaching Hospital (KATH), Kumasi were consecutively recruited between March and August 2021. Age and sex-matched control group of 117 individuals who were HIV-negative blood donors were recruited. Relevant baseline demographic and clinical characteristics were obtained from all participants using a standardized questionnaire. Transthoracic echocardiography was performed for all participants and the predictors of echocardiographic abnormalities were determined using binary logistic regression modelling.

Results: Increasing age (aOR = 5.8; 95% CI, 3.4-9.8; p = 0.04), female gender compared to male gender (aOR = 4.8; 95% CI, 2.4-9.4; p = 0.033), and viral load > 50 copies/mL compared to viral load ≤ 50 copies/ml or undetectable (aOR = 4.4; 95% CI, 2.2-9.0; p < 0.001) were significantly associated with the presence of echocardiographic abnormalities.

Conclusion: Markers of immunosuppression such as HIV viral load > 50 copies/ml and traditional cardiovascular risk factors such as increasing age and female gender were useful in predicting cardiac abnormalities among PLWH in this Ghanaian study. HIV disease and traditional cardiac risk factors must be recognized and aggressively managed to reduce cardiovascular morbidity and mortality among PLWH especially among females given the faster progression to AIDS even at similar levels of viremia compared to males.