Descriptive study of echocardiographic alterations in acquired immunodeficiency syndrome carriers / Estudo descritivo das alterações ecocardiográficas em portadores da síndrome da imunodeficiência adquirida

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Introduction: The morbid-mortality due to the acquired human immunodeficiency virus (HIV) has decreased since the highly active antiretroviral therapy (HAART) was adopted. However, this therapy has contributed to the increase of cardiovascular diseases. The cardiovascular risk can increase both in consequence of the lipidic metabolism alterations, by the direct action of some antiretrovirals, and by the increase in life expectation, which subjects AIDS carriers to the risk of acquiring cardiovascular diseases proper from advanced age. Objectives: To estimate the prevalence of echocardiographic alterations in patients with AIDS and describe this occurrence according to demographic characteristics related to the disease. Method: Transversal study with a sample of hospitalized patients and two other groups from outpatient departments of two reference AIDS services in the city of São Paulo. Hospitalized and outpatient individuals who were set out for exams constitute the group with clinical indication to carry out the echocardiogram, being the other group formed by patients in outpatient departments treatment, who were set out for exams as part of the control group. The participation was voluntary. The study is a secondary data research, carried out through hospital medical records consultation and realization of echocardiogram. Information related to the illness like time with HIV and AIDS, viral load and CD4 counts, use of illicit drugs, time of treatment and antiretroviral type, were collected directly from the patients medical records. The cardiovascular alterations were searched by the echocardiogram, which is a non-invasive exam that permits to identify morphological and functional heart alterations. Results: Fifty-four patients were studied, from which 75.9% were men. The mean age of patients was 40 years old. Three groups were formed, being 20.4% from outpatient departments and without indication for the echocardiogram, 40.7% hospitalized individuals and 38.9% from outpatient departments, both with indication to carry out the echocardiogram. The mean time of HIV infection was 8.4 years, while the mean time with AIDS was 5.3 years. 90% of the participants used HAART and the mean time using these medicines was 6.7 years. The prevalence of at least one of the echocardiographic alterations was 88.9%, and 75.9% of participants presented dyslipidemia. The echocardiographic alterations were associated to the kind of patient treatment, and they were more frequent in the hospitalized group. Other associations were identified, like dyslipidemia and current or previous use of protease inhibitor, independently of age or sex. Conclusions: The high prevalence of echocardiographic alterations found in this study indicates the need to include this exam in the medical follow-up of HIV carriers. It would be ideal if an exam was carried out before the beginning of antiretroviral therapy and other ones were made within a 6-month periodicity, aiming to detect and treat the cardiopathies.

ASSUNTO(S)

dislipidemia ecocardiografia aids haart hiv hiv cardiopathy aids echocardiography cardiopatia haart dyslipidemia

ACESSO AO ARTIGO

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