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(Circulation. 2005;112:3602-3607.)
© 2005 American Heart Association, Inc.

Heart Disease in Africa

Impact of Human Immunodeficiency Virus Infection on Cardiovascular Disease in Africa

Mpiko Ntsekhe, MD; James Hakim, FRCP

From The Cardiac Clinic (M.N.), Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa, and the Department of Medicine (J.H.), University of Zimbabwe, Harare, Zimbabwe.

Correspondence to Dr Mpiko Ntsekhe, The Cardiac Clinic, E25 Groote Schuur Hospital, Anzio Rd, Observatory 7925, South Africa. E-mail mntsekhe{at}uctgsh1.uct.ac.za

Received March 14, 2005; revision received July 19, 2005; accepted July 25, 2005.

Background— Human immunodeficiency virus (HIV) infection is the single greatest health challenge facing Africa today. However, the impact of the HIV epidemic on the cardiovascular system in Africans has received scant attention in the world literature.

Methods and Results— We searched MEDLINE (January 1, 1980, to December 31, 2004) and reference lists of literature on HIV and the heart in Africa and contacted experts in the field. The search for this review yielded 22 articles involving HIV and the cardiovascular system from 8 countries in Africa.

Conclusions— The available information suggests that there are unique features in the etiology, presentation, and spectrum of HIV-associated cardiovascular disorders in people living in Africa. First, pericardial disease may be the initial manifestation of HIV infection in the early stages of the illness. Second, the etiology of cardiac disease tends to reflect the prevalent infectious diseases, such as tuberculosis. Third, unique cardiovascular disorders such as aneurysm of large vessels have been reported in association with HIV infection in several parts of Africa. Finally, the HIV/AIDS pandemic has put pressure on the meager healthcare resources and fragile infrastructure in many African countries, making the diagnosis and treatment of heart disease unrelated to HIV even more difficult.

Key Words: AIDS • cardiomyopathy • pericarditis • pulmonary heart disease • Africa

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