Electrocardiographic Abnormalities in Children with Human Immunodeficiency Virus Infection Presenting to the Federal Medical Centre, Umuahia, South-east Nigeria

Abstract

Background: With the availability of highly active anti-retroviral therapy and attendant increased lifespan of human immunodeficiency virus (HIV)-infected children, late complications of the disease, especially cardiovascular complications have become a growing problem for them. The cardiovascular complications of HIV infection start early in the course of the disease, although may remain asymptomatic until later in life, when they manifest with life-threatening symptoms. The electrocardiogram (ECG) is an invaluable tool in the early diagnosis of these abnormalities. Aim: This study assessed the prevalence and types of ECG abnormalities among HIV-infected children. Patients, Materials and Methods: It was a hospital-based, comparative, cross-sectional study involving randomly selected HIV-infected children (subjects) and age- and gender-matched HIV-uninfected children (controls). Relevant information was obtained through questionnaires, medical records, and physical examination. All participants underwent a 12-lead ECG assessment. Results: Electrocardiographic abnormalities were observed in 42.9% of subjects compared to 17.9% of controls (χ 2 = 8.28; P = 0.004). The participants were about three times more likely to have ECG abnormalities than controls (odds ratio = 3.45, 95% confidence interval = 1.45–8.19). Left ventricular hypertrophy (LVH) was the most common abnormality in the subjects (14.3%), and compared to controls (1.8%), this was significant (χ 2 = 0.032; P = 0.032). Other ECG abnormalities such as right ventricular hypertrophy, T-wave changes, and T-axis abnormalities were more prevalent among subjects (10.7%, 5.4%, and 10.7%, respectively) than controls (1.8%, 3.6%, and 14%, respectively), although not significant. Conclusion: Electrocardiographic abnormalities are quite prevalent among HIV-infected children, with LVH being predominant. It is recommended that routine ECG evaluations be done on HIV-infected children to enable the early detection and prompt management of these problems.