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JG Hakim
University of Zimbabwe Clinical Research Centre
                                         Harare
                                     Zimbabwe
Heart Disease in HIV Infection
 Myocardium
    Cardiomyopathy or HIV associated Heart Disease
    Conduction abnormalities
    ? Impact on coronary artery disease
 Endocardium
    Endocarditis-infective, but also non-infective
 Pericardium
    Non-infective
    Infective-TB
 Vascular Disease
    Aneurysms
Interest
 Pericardial Disease
    Role of adjunctive steroids
        Mortality
        Morbidity
          Quality of life

          Constrictive pericarditis

 HIV associated Cardiomyopathy
   Presentation
   Prognosis
Heart Disease and HIV infection
 Medical
   Does HIV infection modify manifestations, presentation
    and approach to heart disease?
   HAART and heart disease
       AZT-cardiotoxicity
       ATV-heart block
       PIs & other ARVs- dyslipedemia, insulin resistance, Diabetes
        mellitus-risk factors for CAD
   WHO Staging
     Extra-pulmonary TB-stage IV
     Toxoplasmosis-stage IV
     HIV associated Cardiomyopathy-stage IV
Heart Disease and HIV infection
 Surgical
    Cardiac
       Valvular heart disease
       Coronary artery disease
       Other
   Non-cardiac
       Precautions for surgery and anaesthesia

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Hiv & the heart

  • 1. JG Hakim University of Zimbabwe Clinical Research Centre Harare Zimbabwe
  • 2. Heart Disease in HIV Infection  Myocardium  Cardiomyopathy or HIV associated Heart Disease  Conduction abnormalities  ? Impact on coronary artery disease  Endocardium  Endocarditis-infective, but also non-infective  Pericardium  Non-infective  Infective-TB  Vascular Disease  Aneurysms
  • 3. Interest  Pericardial Disease  Role of adjunctive steroids  Mortality  Morbidity  Quality of life  Constrictive pericarditis  HIV associated Cardiomyopathy  Presentation  Prognosis
  • 4. Heart Disease and HIV infection  Medical  Does HIV infection modify manifestations, presentation and approach to heart disease?  HAART and heart disease  AZT-cardiotoxicity  ATV-heart block  PIs & other ARVs- dyslipedemia, insulin resistance, Diabetes mellitus-risk factors for CAD  WHO Staging  Extra-pulmonary TB-stage IV  Toxoplasmosis-stage IV  HIV associated Cardiomyopathy-stage IV
  • 5. Heart Disease and HIV infection  Surgical  Cardiac  Valvular heart disease  Coronary artery disease  Other  Non-cardiac  Precautions for surgery and anaesthesia