Assessment of Right Ventricular Systolic Function using Tricuspid Annular Plane Systolic Excursion (TAPSE) among HIV Patients on HAART and Its Relationship with Viral Load and CD4 Cell Count

M. M. Baba, F. Buba, M. A. Talle, M. A. Garbati, Habu Abdul

Abstract

BACKGROUND: The introduction of highly active antiretroviral
therapy (HAART) has decreased the morbidity and mortality associated
with HIV infection; however, this survival advantage is not free from
complications. HIV patients are more likely to develop cardiovascular
disease compared with the general population, and right ventricular
systolic dysfunction is said to be associated with worse outcomes. We
therefore sought to assess right ventricular systolic function using
tricuspid annular plain systolic excursion (TAPSE) among HIV patients
on HAART and its relationship with viral load and CD4 cell count.

METHODS: The study was a cross-sectional conducted among HIV
patients receiving HAART at the Federal Medical Centre, Nguru, Yobe
State, Northeastern Nigeria. Right ventricular systolic function was
assessed using tricuspid annular plane systolic excursion.

RESULTS: One hundred and seven (107) subjects were recruited into the
study comprising thirty-seven (34.6%) males and seventy (65.4%)
females. The mean CD4 cell count and viral load of the studied patients
were 612.65 ± 347.62 cells/μL and 315.44±271.11copies/mL,
respectively. The distribution of RVSF according to CD4 cell count
showed, fifteen (14.01%) patients with CD4 cell count less than 250 had
reduced right ventricular systolic function (RVSF), 30 (28.03%) patients
with CD4 cell count 250 – 500 had reduced RVSF, 1 (0.93%) patient with
CD4 cell count 250 – 500 had normal RVSF, 47 (43.92%) patients with
CD4 cell count 501 -1,000 had normal RVSF and 14(13.08%) patients
with CD4 cell count greater than 1,000 had normal RVSF. Fourteen
(13.08%) patients with undetectable viral load had normal RVSF,
47(43.92%) patients with viral load 50 – 1,500 had normal RVSF,
1(0.93%) patient with viral load 1,501 – 10,000 had normal RVSF,
30(28.03%) patients with viral load 1,501 – 10,000 had reduced RVSF and
15(14.01%) patients with viral load 10,000 – 50,000 had reduced RVSF.
There was a positive and significant correlation between tricuspid
annular plain systolic excursion with CD4 cell count and a negative but
significant correlation HIV viral load.

CONCLUSION: We therefore concluded that asymptomatic right
ventricular systolic dysfunction exists among patients with HIV infection
and there was positive and significant correlation between tricuspid
annular plain systolic excursion with CD4 cells count and a negative but
significant correlation HIV viral load.

KEY WORDS: Right ventricular systolic function, tricuspid annular
plane systolic excursion (TAPSE) CD4 cells, viral load.