Left Ventricular Systolic Dysfunction in the Antiretroviral Therapy Era: A Call for Comprehensive Cardiovascular Management in People Living with HIV in Ethiopia

Abinet Tekalign Manyahilal¹, Dufera mekonnen², Amanuel Gebreselassie Tesfaye¹, Zekarias Seifu Ayalew³, Gebeyehu Tessema Azibte^3, , Biruk Abate legesse³ and Samuel Tsehaye Gebremedhin⁴

¹Federal prison Administration General hospital, Addis Ababa, Ethiopia

²Division of Cardiology, Department of Internal Medicine, Addis Ababa University, College of Medicine and Health Sciences, Addis Ababa, Ethiopia.

³Department of Internal Medicine, Addis Ababa University, College of Medicine and Health Sciences, Addis Ababa, Ethiopia

⁴Department of Neurology, Saint Peter Specialized Hospital, Addis Ababa, Ethiopia

Cite this paper:
Abinet Tekalign Manyahilal, Dufera mekonnen, Amanuel Gebreselassie Tesfaye, Zekarias Seifu Ayalew, Gebeyehu Tessema Azibte, Biruk Abate legesse and Samuel Tsehaye Gebremedhin. Left Ventricular Systolic Dysfunction in the Antiretroviral Therapy Era: A Call for Comprehensive Cardiovascular Management in People Living with HIV in Ethiopia. American Journal of Infectious Diseases and Microbiology. 2024; 12(2):29-36. doi: 10.12691/ajidm-12-2-2

Abstract

Background: Access to antiretroviral therapy (ART) has transformed HIV infection into a chronic disease. However, cardiovascular disease (CVD) is now a leading cause of morbidity and mortality among people living with HIV (PLWH). This study assessed the prevalence and predictors of left ventricular systolic dysfunction (LVSD) among PLWH in Ethiopia. Methods: An institution-based cross-sectional study involving 156 PLWH was conducted. Medical records were reviewed, and a structured questionnaire was used to collect data on demographics, clinical characteristics, medications, and echocardiography findings. Binary logistic regression identified factors associated with LVSD (p<0.05). Results: LVSD prevalence was 19%, with ischemic heart disease (75%) as the primary cause. Echocardiography revealed abnormalities in 40% of participants, with ischemic heart disease (16.6%) being the most frequent. Dyslipidemia (51.6%) and hypertension (30.8%) were the most common traditional risk factors. After adjusting for covariates, diabetes mellitus (AOR=14.7, p=0.009), age (AOR=12.2, p=0.073), sex (AOR=7.4, p=0.006), presence of cardiac signs (AOR=6.6, p=0.011), duration of HIV illness (p=0.005) and ART exposure (p=0.03), and stage IV HIV (AOR=8.9, p=0.008) were independent predictors of LVSD. Conclusion: LVSD is prevalent among PLWH in Ethiopia, with ischemic heart disease being the leading cause. Traditional risk factors and HIV-related factors contribute to LVSD. These findings highlight the need for comprehensive CVD management strategies in PLWH.

Keywords:
HIV ART left ventricular systolic dysfunction People living with HIV (PLWH) cardiovascular disease ischemic heart disease

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