A study on echocardiographic and electrocardiographic findings in HIV‑infected patients and their correlation with CD4 counts

Background: Human Immunodeficiency Virus (HIV) infection is linked to a range of cardiovascular complications including cardiomyopathy, pericardial disease, pulmonary hypertension, and coronary artery disease whether or not patients receive antiretroviral therapy (ART). The degree of immune suppression, measured by CD4 cell count, is a critical predictor of cardiovascular involvement in people living with HIV (PLHIV).

Objective: To assess the prevalence and types of electrocardiographic (ECG) and echocardiographic (ECHO) abnormalities in HIV-positive patients, and to determine their correlation with CD4 cell counts.

Methods: This hospital-based observational study included HIV-positive patients on ART. Each participant underwent clinical evaluation, ECG, 2D ECHO, and CD4 cell count testing. The prevalence of cardiac abnormalities and their relationship to CD4 levels were analyzed statistically (SPSS). Echocardiographic findings evaluated included diastolic dysfunction, systolic dysfunction, pericardial effusion, and pulmonary hypertension.

Results: Significant cardiovascular abnormalities were most frequent in patients with CD4 counts below 200 cells/μL. ECG changes included sinus tachycardia, QT prolongation, and repolarization abnormalities. ECHO revealed a high incidence of diastolic dysfunction, reduced ejection fraction, and pericardial effusions. A statistically significant association was found between lower CD4 counts and greater cardiovascular involvement, suggesting advanced immunosuppression accelerates cardiac dysfunction in HIV.

Conclusion: HIV-infected individuals face elevated risk of cardiovascular abnormalities, particularly as CD4 counts decline. Routine cardiovascular screening with ECG and ECHO—especially for those with low CD4 levels—is advised to enable early detection and management, thereby reducing morbidity and mortality among PLHIV.