The 12-month period prevalence and cardiac manifestations of HIV in patients with acute coronary syndrome at a tertiary hospital in Cape Town, South Africa : a retrospective cross-sectional study
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: HIV-positive patients are increasingly being affected by non-communicable diseases such as coronary
artery disease (CAD). Data from high-income countries (HICs) indicate that HIV-positive patients have different riskfactor
profiles for acute coronary syndrome (ACS) as well as different cardiac manifestations of this syndrome
compared to HIV-negative patients. There is limited data from Sub-Saharan Africa (SSA), and particularly from South
Africa with the biggest HIV epidemic in the world. The objective of this study was to determine the 12-month
period prevalence of HIV in patients with ACS and to compare the risk-factor profile, ACS presentation and
management between HIV-positive and HIV-negative adults.
Methods: We included all patients hospitalised with ACS from 01 January to 31 December 2018 in a tertiary
hospital, Tygerberg Hospital, in Cape Town, South Africa. The HIV-status of all patients was determined using
routine clinical records. We performed multiple conditional logistic regression on HIV-positive and HIV-negative
patients (1:3 ratio) to compare the risk factor profile, ACS presentation and management between the groups.
Results: Among 889 patients, 30 (3.4%) were HIV-positive (95% confidence interval (CI): 2.3–4.8). HIV-positive
patients were younger, more frequently men, and had a lower prevalence of medical comorbidities and a family
history of CAD. They were more likely to present with ST-elevation myocardial infarction (STEMI) [odd’s ratio (OR)
(95% CI): 3.12 (1.2–8.4)], and have single-vessel disease [OR (95% CI): 3.03 (1.2–8.0)]. Angiographic and
echocardiographic data, as well as management, did not differ between the groups. Among HIV-positive patients,
17 (65%) were virally suppressed (HIV viral load < 200 copies/mL) with a median CD4+ count of 271 cells/mm3. The
majority (20, 67%) of HIV-positive patients were receiving antiretroviral therapy at the time of the ACS.
Conclusions: We found an HIV-prevalence of 3.4% (95% CI 2.3–4.8) in adults with ACS in a high endemic HIV
region. HIV-positive patients were younger and more likely to present with STEMIs and single-vessel disease, but
had fewer CAD risk factors, suggesting additional mechanisms for the development of ACS.
Description
CITATION: Pennefather, C., et al. 2021. The 12-month period prevalence and cardiac manifestations of HIV in patients with acute coronary syndrome at a tertiary hospital in Cape Town, South Africa : a retrospective cross-sectional study. BMC Infectious Diseases, 21:657, doi10.1186/s12879-021-06367-2.
The original publication is available at https://bmcinfectdis.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund
The original publication is available at https://bmcinfectdis.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund
Keywords
Cardiac manifestations, HIV-positive persons, Coronary disease, Coronary heart disease
Citation
Pennefather, C., et al. 2021. The 12-month period prevalence and cardiac manifestations of HIV in patients with acute coronary syndrome at a tertiary hospital in Cape Town, South Africa : a retrospective cross-sectional study. BMC Infectious Diseases, 21:657, doi10.1186/s12879-021-06367-2