Pattern of electrocardiographic abnormalities in pediatric HIV/AIDS clients at Federal Medical Center, Abeokuta

Abstract

Background: Sub-Saharan Africa presently contributes about 70% of global HIV/AIDS population with little or no emphasis on the contribution of cardiovascular abnormalities to the associated morbidity and mortality in the region. Objectives: The objective is to determine the prevalence of electrocardiographic (ECG) abnormalities and association of such abnormalities with HIV/AIDS severity in terms of clinical manifestations and level of CD4 depletion. Design: A hospital-based cross-sectional case-control study. Methodology: One hundred and five (105) HIV-infected children attending HIV clinic and equivalent age- and sex-matched HIV un-infected controls attending pediatrics General Outpatient Clinics at FMCA were consecutively recruited over 8 months. They were evaluated clinically and had CD4 count, hematocrit, plasma calcium and potassium, and standard 12-lead ECG done. Results: Thirty-five (33.3%) of the subjects had ECG abnormalities compared with four (3.8%) in the controls (χ2 = 28.34, P < 0.05). The left ventricular hypertrophy was the commonest (13.3%) among other detected abnormalities such as Q-wave abnormalities, right ventricular hypertrophy, and ventricular repolarization abnormalities. The detected abnormalities were not significantly associated with advanced clinical or immunological stage of HIV/AIDS (χ2 < 4.0, P > 0.05). Conclusion: There was a high prevalence of ECG abnormalities in children with HIV/AIDS. These abnormalities occurred irrespective of the extent of the disease advancement. There is therefore a need for at least an ECG to identify from among HIV infected children those who may subsequently require echocardiography since the cost of echocardiography is presently too high and precludes its routine use in the Sub-Saharan Africa.