Valvular manifestations of human immunodeficiency virus infection--results from the prospective, multicenter HIV-HEART study

J Cardiovasc Med (Hagerstown). 2013 Oct;14(10):733-9. doi: 10.2459/JCM.0b013e32835dc953.

Abstract

Background and aims: HIV infection is associated with an elevated rate of cardiac diseases. The aim of the current study was to assess the prevalence of valvular disorders in a large population of HIV-infected patients.

Methods: We enrolled 803 adults (age 44 ± 10 years, 16.6% women) in this prospective, multicenter cohort study. All patients underwent a comprehensive two-dimensional transthoracic echocardiography examination including Doppler evaluation of valvular function. Statistical analyses were performed in respect of severity of HIV infection.

Results: Overall, the rate of patients with pathologic function of cardiac valves was 77.6% (N = 623). Most of these patients had signs of valvular regurgitation (N = 620; 77.2%), whereas stenoses were rare (N = 23; 2.9%). Clinically relevant valvular disorders (excluding mild stages) were seen in only 4.7% (N = 38; regurgitation: N = 36, 4.5%; stenosis: N = 3, 0.4%). Clinical stages of HIV infection, defined by the Centers for Disease Control and Prevention (CDC) classification, were associated with higher rates of valvular diseases (CDC-stage B/C versus A: 6.2 versus 2.3%, P = 0.015). However, there was no association between current CD4 cell count or virus load and the prevalence of valvular disorders (both P > 0.2). None of the patients had signs of active endocarditis in the present study.

Conclusion: Valvular heart diseases are common in HIV-infected patients. Fortunately, most of these disorders are mild today. We found an association between the onset of valvular heart disease and clinical stages of HIV infection.

Trial registration: ClinicalTrials.gov NCT01119729.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • CD4 Lymphocyte Count
  • Cross-Sectional Studies
  • Echocardiography, Doppler
  • Female
  • Germany / epidemiology
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology*
  • HIV Infections / physiopathology
  • HIV Infections / virology
  • Heart Valve Diseases / diagnosis
  • Heart Valve Diseases / epidemiology*
  • Heart Valve Diseases / physiopathology
  • Heart Valve Diseases / virology
  • Heart Valves* / diagnostic imaging
  • Heart Valves* / physiopathology
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Severity of Illness Index

Associated data

  • ClinicalTrials.gov/NCT01119729