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  • OA-223 Myocardial structure and function assessed by cardiac magnetic resonance in adolescents with perinatal-acquired HIV infection taking antiretroviral therapy

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OA-223 Myocardial structure and function assessed by cardiac magnetic resonance in adolescents with perinatal-acquired HIV infection taking antiretroviral therapy
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  1. Edith Majonga1,2,
  2. Miriam Lacharie3,
  3. Azlan Helmy Abd Samat3,
  4. Betty Raman3,
  5. Hilda Mujuru4,
  6. Kirti Naik5,
  7. Rashida Ferrand1,6,
  8. Masliza Mahmod3
  1. 1Biomedical Research and Training Institute, Zimbabwe
  2. 2Department of Medical Physics and Imaging Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
  3. 3University of Oxford Centre for Clinical Magnetic Resonance Research, UK
  4. 4Child and Adolescent Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
  5. 5Baines Imaging Group, Zimbabwe
  6. 6Department of Clinical Research, London School of Hygiene and Tropical Medicine, UK

Abstract

Background HIV in adolescents with perinatal HIV (PHIV) is associated with an increased risk of cardiac disease, which is not well characterised. We characterised myocardial structure and function in adolescents with PHIV and established on antiretroviral therapy (ART) using advanced imaging with cardiac magnetic resonance (CMR).

Methods We conducted a cross-sectional study in PHIV aged 10–19 years taking antiretroviral therapy and an HIV-negative comparison group in Harare, Zimbabwe. Participants underwent a 3-Tesla CMR examination including assessment of myocardial structure and function (cine) and myocardial fibrosis (late gadolinium enhancement, LGE). Groups were compared using unpaired t-test, and potential predictors were assessed with multiple linear regression.

Results Forty-four participants were included in the analysis (n= 23 with HIV; 52% female and 21 uninfected controls; 48% female]). Participants with PHIV were older [median (IQR) 18 (16–19) vs 15 (13–17) years; p=0.002] compared to uninfected controls. They also had lower height-for-age and weight-for-age z-scores [Mean (SD), -1.84 (1.0) vs 1.17 (1.0); p=0.044] and [-1.35 (1.4) vs -0.21 (1.4); p=0.011] respectively. In the PHIV group, median age at HIV diagnosis was 5.5 (IQR, 4–8) years and 18 (82%) were virally suppressed (<19 copies/ml). The PHIV group had a larger indexed left ventricular (LV) mass [Mean (SD), 39.2 (5.4) vs 35.3 (6.4) g/m2; p=0.047] and LV end-diastolic volume [75.0 (8.2) vs 67.5 (12.5) mL/m2; p=0.026] compared to controls. LV and right ventricular systolic function measured by either ejection fraction or strain was normal in both groups, and no LGE was observed. No association of LV systolic function was observed with age, sex, and HIV viral load.

Conclusion In this interim analysis, an increased indexed LV mass and end-diastolic LV volume in the PHIV group relative to those HIV-negative may suggest LV structural changes. Recruitment is ongoing and comprehensive regression modelling shall be performed.

Funding: EDCTP TMA2019CDF-2776

https://doi.org/10.1136/bmjgh-2023-EDC.17

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