Prevalence of Electrocardiogram Abnormalities in Human Immunodeficiency Virus-Infected Children
American Journal of Pediatrics
Volume 6, Issue 1, March 2020, Pages: 22-26
Received: Dec. 17, 2019; Accepted: Jan. 10, 2020; Published: Feb. 7, 2020
Views 87      Downloads 42
Authors
Ni Luh Sri Apsari, Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Indonesia
Eka Gunawijaya, Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Indonesia
Ni Putu Veny Kartika Yantie, Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Indonesia
Ketut Dewi Kumara Wati, Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Indonesia
Komang Ayu Witarini, Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Indonesia
Hendra Santoso, Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Indonesia
Article Tools
Follow on us
Abstract
HIV is an important cause of childhood morbidity and mortality affecting more than 1.3 million children worldwide, one of the morbidity is cardiac abnormalities. Cardiovascular abnormalities are still subclinical during childhood then become symtomatic in adulthood. Electrocardiography is effective to detect cardiac diseases. This study aimed to assess ECG changes in HIV infected children and describe ECG abnormalities in HIV-infected children with or without HAART. From 70 subjects, we found the most common abnormality was sinus tachycardia in 17 patients (24.3%), sinus bradycardia 1 patient (1.4%) and 2 patients with sinus arrhythmia (2.9%). The mean QTc interval was 0.42 seconds (±0.07) and 14 patients (20%) had prolongation. The mean PR interval was 0.12 seconds (±0.02), 11 patients (15.7%) experienced prolongation of PR interval. The mean QRS duration was 0.06 seconds (±0.09). Left ventricular enlargement was present in 6 patients (8.6%), conduction disturbance which is characterized by Bundle branch block was found in 2 patients (2.9%) and ST changes was seen in 2 patients (2.9%). Other ECG abnormalities are characterized by right ventricle hyperthropy in 4 patients and a patient had T tall. The prevalence of cardiac abnormalities based on ECG examination from this study was 51.3%, consist of heart rhythm abnormality, prolonged PR interval, prolonged QTc interval, bundle branch block, ventricle hypertrophy and ST changes.
Keywords
Electrocardiography, HIV, HAART, Children
To cite this article
Ni Luh Sri Apsari, Eka Gunawijaya, Ni Putu Veny Kartika Yantie, Ketut Dewi Kumara Wati, Komang Ayu Witarini, Hendra Santoso, Prevalence of Electrocardiogram Abnormalities in Human Immunodeficiency Virus-Infected Children, American Journal of Pediatrics. Vol. 6, No. 1, 2020, pp. 22-26. doi: 10.11648/j.ajp.20200601.13
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
S. Lubega, G. W. Zirembuzi, P. Lwabi. Heart disease among children with HIV/AIDS attending the paediatric infectious disease clinic at Mulago Hospital. African health sciences. 2005; 5 (3): 219-26.
[2]
UNAIDS. 2012 Report on the Global AIDS epidemic. http://www.unaids.org.
[3]
A. Sims, C. Hadigan. Cardiovascular complications in children with HIV infection. Curr HIV/AIDS Rep. 2011; 8: 209-14.
[4]
N. S. Idris, D. E. Grobbee, D. Burgner, et al. Cardiovascular manifestations of HIV infection in children. Eur J Prev Cardiol. 2015; 22: 1452-61.
[5]
S. E. Lipshultz, K. A. Easley, E. J. Orav, S. Kaplan, T. J. Starc, et al. Cardiac dysfunction and mortality in HIV-infected children: the prospective P2C2HIV multicentre study: pediatric pulmonary and cardiovascular complications of vertically transmitted human immunodeficiency virus (P2C2 HIV) study group. Circulation. 2000; 102: 1542-8.
[6]
C. Am, G. J. Nuovo. Histologic and in situ viral findings in the myocardium in cases of sudden, unexpected death. Mod Pathol. 2002; 15: 914-22.
[7]
R. H. Merchant, M. M. Lala. Common clinical problems in children living with HIV/AIDS: systemic approach. Indian J Pediatr. 2012; 79: 1506–13.
[8]
S. E. Lipshultz. Dilated cardiomyopathy in HIV-infected patients. N Engl J Med. 1998; 339 (16): 1153-5.
[9]
W. G. Harmon, G. H. Dadlani, S. D. Fisher, S. E. Lipshultz. Myocardial and pericardial disease in HIV. Curr Treat Options Cardiovasc Med. 2002; 4 (6): 497-509.
[10]
I. C. Okoye, E. N. Anyabolu. Electrocardiographic abnormalities in treatment-naïve HIV subjects in south-east Nigeria. Cardiovasc J Afr. 2017; 28: 1-5.
[11]
N. Patel, S. Abdelsayed, M. Veve, C. D. Miller. Predictors of clinically significant drug-drug interactions among patients treated with nonnucleoside reverse transcriptase inhibitor-, protease inhibitor, and raltegravir-based antiretroviral regimens. Ann Pharmacother. 2011; 45 (3): 317.
[12]
M. U. Sani, B. N. Okeahialam, Jos, Kano. QTc interval prolongation in patients with HIV and AIDS. J Natl Med Assoc. 2005; 97: 1657-1661.
[13]
P. O. Njoku, E. C. Ejim, B. C. Anisiuba, S. O. Ike, B. J. C. Onwubere. Electrocardiographic findings in a cross-sectional study of human immunodeficiency virus (HIV) patients in Enugu, south-east Nigeria. Cardiovasc J Afr. 2016; 27: 252-257.
[14]
I. C. Okoye, N. D. Anyabolu. Electrocardiographic abnormalities in treatment-naïve HIV subjects in south-east Nigeria. Cardiovasc J Afr. 2017; 28 (5): 315-318.
[15]
R. C. McIntosh, J. D. Lobo, B. E. Hurwitz. Current assessment of heart rate variability and QTc interval length in HIV/AIDS. Curr Opin HIV AIDS. 2017; 12 (6): 528-533.
[16]
S. Nalmas, R. Nagarakanti, J. Slim, E. Abter, E. Bishburg. Electrocardiographic changes in infectious diseases. Hospital Physician. 2007; 15-27.
[17]
B. Charbit, E. Gayat, P. Voiriot, F. Boccara, P. M. Girard, C. Funck-Brentano. Effects of HIV Protease Inhibitors on cardiac conduction velocity in unselected hiv-infected patients. Clin Pharmacol Ther. 2011; 9: 1-7.
[18]
N. S. Idris, M. M. H. Cheung, D. E. Grobbee, D. Burgner, N. Kurniati et al. Effects of paediatric HIV infection on electrical conduction of the heart. Open Heart. 2016; 3: 1-8.
[19]
J. B. Nielsen, A. Pietersen, C. Graff, B. Lind, JJ Struijk et al. Risk of atrial fibrillation as a function of the electrocardiographic PR interval: results from the Copenhagen ECG Study. Heart Rhythm. 2013; 10: 1249-56.
[20]
S. Cheng, M. J. Keyes, M. G. Larson, E. L. McCabe, C Newton-Cheh et al. Long-term outcomes in individuals with prolonged PR interval or first-degree atrioventricular block. JAMA. 2009; 301: 2571–7.
[21]
O. Ige, S. Oguche, C. Yilgwan, H. Abdu, F. Bode-Thomas. The QT interval in human immunodeficiency virus-positive Nigerian children. J Med Trop. 2014; 16: 61.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186