title: Cardiac Dysfunction Among Ugandan HIV-infected Children on Antiretroviral Therapy.
abstract: BACKGROUND
  Despite effective antiretroviral therapy (ART), HIV-infected children on treatment have been observed to have cardiac abnormalities. We sought to determine the prevalence, types and factors associated with cardiac abnormalities among HIV-infected Ugandan children on combination ART.
  
  
  METHODS
  We carried out a cross-sectional study from July 2012 to January 2013, at Joint Clinical Research Centre among HIV-infected children aged 1-18 years. Cardiac abnormalities were assessed using electrocardiography and echocardiography. CD4 counts, viral load and complete blood count were performed at enrollment. The prevalence of cardiac abnormalities was determined using simple proportions with the associated factors ascertained using logistic regression.
  
  
  RESULTS
  Among 285 children recruited, the median (interquartile range) age was 9 (6-13) years, 54% were female; 72% were on first line combination ART. Their mean (±SD) CD4 count was 1092 (±868.7) cells/mm; median (interquartile range) viral load was 20 (20-76) copies/mL. Ninety-four percent had adherence to ART of more than 95%. Cardiac abnormalities were detected in 39 (13.7%) children. The most common abnormalities by electrocardiography and echocardiography were nonspecific T wave changes (4.6%) and pericardial disease (thickened pericardium with or without pericardial effusion; 2.8%), respectively. No factor assessed was found to be significantly associated occurrence of cardiac dysfunction.
  
  
  CONCLUSIONS
  The prevalence of cardiac dysfunction among the HIV-infected children on ART was 13.7%, which was high, with nonspecific T wave changes and pericardial disease being the most frequent abnormalities observed. No factor assessed was found to be associated with cardiac dysfunction.
authors.affiliation: From the *Department of Paediatrics, Makerere University College of Health Sciences; †Pediatric Cardiology Department, Uganda Heart Institute, Mulago Hospital; ‡Directorate of Research and Grants, Joint Clinical Research Centre (JCRC); and §Clinic Department, Makerere University-John Hopkins University (MUJHU) Care Limited, Kampala, Uganda.
authors.forename: Judith
authors.initials: J
authors.lastname: Namuyonga
authors.forename: Sulaiman
authors.initials: S
authors.lastname: Lubega
authors.forename: Victor
authors.initials: V
authors.lastname: Musiime
authors.forename: Peter
authors.initials: P
authors.lastname: Lwabi
authors.forename: Irene
authors.initials: I
authors.lastname: Lubega
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D010349:Patient Compliance; D015995:Prevalence; D012307:Risk Factors; D014454:Uganda / Q000453:epidemiology; D019562:Viral Load