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
| dc.contributor.author | Pennefather, Camilla | en_ZA |
| dc.contributor.author | Esterhuizen, Tonya | en_ZA |
| dc.contributor.author | Doubell, Anton | en_ZA |
| dc.contributor.author | Decloedt, Eric H. | en_ZA |
| dc.date.accessioned | 2021-08-04T13:31:20Z | |
| dc.date.available | 2021-08-04T13:31:20Z | |
| dc.date.issued | 2021 | |
| dc.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. | |
| dc.description | The original publication is available at https://bmcinfectdis.biomedcentral.com | |
| dc.description | Publication of this article was funded by the Stellenbosch University Open Access Fund | |
| dc.description.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. | en_ZA |
| dc.description.uri | https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06367-2 | |
| dc.description.version | Publisher's version | |
| dc.format.extent | 10 pages | en_ZA |
| dc.identifier.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 | |
| dc.identifier.issn | 1471-2334 (online) | |
| dc.identifier.other | doi10.1186/s12879-021-06367-2 | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/110805 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | BMC (part of Springer Nature) | en_ZA |
| dc.rights.holder | Authors retain copyright | en_ZA |
| dc.subject | Cardiac manifestations | en_ZA |
| dc.subject | HIV-positive persons | en_ZA |
| dc.subject | Coronary disease | en_ZA |
| dc.subject | Coronary heart disease | en_ZA |
| dc.title | 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 | en_ZA |
| dc.type | Article | en_ZA |