title: Prevalence of myocarditis and cardiotropic virus infection in Africans with HIV-associated cardiomyopathy, idiopathic dilated cardiomyopathy and heart transplant recipients: a pilot study: cardiovascular topic.
abstract: BACKGROUND
  The prevalence of myocarditis and cardiotropic viral infection in human immunodeficiency virus (HIV)-associated cardiomyopathy is unknown in Africa.
  
  
  METHODS
  Between April 2002 and December 2007, we compared the prevalence of myocarditis and cardiotropic viral genomes in HIV-associated cardiomyopathy cases with HIV-negative idiopathic dilated cardiomyopathy patients (i.e. negative controls for immunodeficiency) and heart transplant recipients (i.e. positive controls for immunodeficiency) who were seen at Groote Schuur Hospital, Cape Town, South Africa. Myocarditis was sought on endomyocardial biopsy using the imunohistological criteria of the World Heart Federation in 33 patients, 14 of whom had HIV-associated cardiomyopathy, eight with idiopathic dilated cardiomyopathy and 11 heart transplant recipients.
  
  
  RESULTS
  Myocarditis was present in 44% of HIV-associated cardiomyopathy cases, 36% of heart transplant recipients, and 25% of participants with idiopathic dilated cardiomyopathy. While myocarditis was acute in 50% of HIV- and heart transplant-associated myocarditis, it was chronic in all those with idiopathic dilated cardiomyopathy. Cardiotropic viral infection was present in all HIV-associated cardiomyopathy and idiopathic dilated cardiomyopathy cases, and in 90% of heart transplant recipients. Multiple viruses were identified in the majority of cases, with HIV-associated cardiomyopathy, heart transplant recipients and idiopathic dilated cardiomyopathy patients having an average of 2.5, 2.2 and 1.1 viruses per individual, respectively.
  
  
  CONCLUSIONS
  Acute myocarditis was present in 21% of cases of HIV-associated cardiomyopathy, compared to none of those with idiopathic dilated cardiomyopathy. Infection with multiple cardiotropic viruses may be ubiquitous in Africans, with a greater burden of infection in acquired immunodeficiency states.
authors.forename: Gasnat
authors.initials: G
authors.lastname: Shaboodien
authors.forename: Christopher
authors.initials: C
authors.lastname: Maske
authors.forename: Helen
authors.initials: H
authors.lastname: Wainwright
authors.forename: Heidi
authors.initials: H
authors.lastname: Smuts
authors.forename: Mpiko
authors.initials: M
authors.lastname: Ntsekhe
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Commerford
authors.forename: Motasim
authors.initials: M
authors.lastname: Badri
authors.forename: Bongani M
authors.initials: BM
authors.lastname: Mayosi
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D044383:Black People; D009202:Cardiomyopathies / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D010865:Pilot Projects; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology