The implications of HIV infection on the management of valvular heart disease in Southern Africa

There is very limited information on the disease profile and treatment approaches in HIV patients with valvular heart disease (VHD) in developing countries. HIV infection impacts on patients with VHD in three settings: HIV/Aids as a comorbid disease in patients with underlying valve disease, infecti...

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Autores principales:	D.P. Naidoo, K. Shein
Formato:	article
Lenguaje:	EN
Publicado:	South African Heart Association 2017
Materias:	hiv valvular heart disease southern africa Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/673ea6001460487586d905376e2972b4
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spelling	oai:doaj.org-article:673ea6001460487586d905376e2972b42021-11-22T06:55:58ZThe implications of HIV infection on the management of valvular heart disease in Southern Africa10.24170/6-2-19931996-67412071-4602https://doaj.org/article/673ea6001460487586d905376e2972b42017-04-01T00:00:00Zhttps://www.journals.ac.za/index.php/SAHJ/article/view/1993https://doaj.org/toc/1996-6741https://doaj.org/toc/2071-4602There is very limited information on the disease profile and treatment approaches in HIV patients with valvular heart disease (VHD) in developing countries. HIV infection impacts on patients with VHD in three settings: HIV/Aids as a comorbid disease in patients with underlying valve disease, infective endocarditis secondary to immunosuppression, and non-infective valve involvement from myocardial failure or from marantic endocarditis. The clinical presentation of infective endocarditis does not differ between HIV and non-HIV patients, with the exception that intravenous drug abuse is a common cause in specific populations. While peri-operative mortality and morbidity is high in acute infective endocarditis, surgical interventions do not increase the postoperative risk for complications or death and should therefore not be withheld. There is also little evidence to suggest that HIV or antiretroviral drugs increase the rate of cardiac-related pregnancy complications or that pregnancy may alter the course of HIV infection. Since antiretroviral therapy has been associated with considerable improvement in clinical status prior to surgery, as well as in long term outcomes, all patients with valve disease in whom intervention is likely should undergo HIV testing and staging so that highly active antiretroviral treatment (HAART) may be instituted timeously. Conclusion: The high prevalence of HIV in our population makes consideration of this comorbidity an essential facet in the routine evaluation and management of patients with VHD. There is solid evidence that these patients do no worse than non-HIV patients undergoing medical treatment or percutaneous/surgical intervention – open-heart surgery may be offered safely to patients with HIV if proper precautions are taken.D.P. NaidooK. SheinSouth African Heart Associationarticlehivvalvular heart diseasesouthern africaDiseases of the circulatory (Cardiovascular) systemRC666-701ENSA Heart Journal, Vol 6, Iss 2, Pp 64-74 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	hiv valvular heart disease southern africa Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	hiv valvular heart disease southern africa Diseases of the circulatory (Cardiovascular) system RC666-701 D.P. Naidoo K. Shein The implications of HIV infection on the management of valvular heart disease in Southern Africa
description	There is very limited information on the disease profile and treatment approaches in HIV patients with valvular heart disease (VHD) in developing countries. HIV infection impacts on patients with VHD in three settings: HIV/Aids as a comorbid disease in patients with underlying valve disease, infective endocarditis secondary to immunosuppression, and non-infective valve involvement from myocardial failure or from marantic endocarditis. The clinical presentation of infective endocarditis does not differ between HIV and non-HIV patients, with the exception that intravenous drug abuse is a common cause in specific populations. While peri-operative mortality and morbidity is high in acute infective endocarditis, surgical interventions do not increase the postoperative risk for complications or death and should therefore not be withheld. There is also little evidence to suggest that HIV or antiretroviral drugs increase the rate of cardiac-related pregnancy complications or that pregnancy may alter the course of HIV infection. Since antiretroviral therapy has been associated with considerable improvement in clinical status prior to surgery, as well as in long term outcomes, all patients with valve disease in whom intervention is likely should undergo HIV testing and staging so that highly active antiretroviral treatment (HAART) may be instituted timeously. Conclusion: The high prevalence of HIV in our population makes consideration of this comorbidity an essential facet in the routine evaluation and management of patients with VHD. There is solid evidence that these patients do no worse than non-HIV patients undergoing medical treatment or percutaneous/surgical intervention – open-heart surgery may be offered safely to patients with HIV if proper precautions are taken.
format	article
author	D.P. Naidoo K. Shein
author_facet	D.P. Naidoo K. Shein
author_sort	D.P. Naidoo
title	The implications of HIV infection on the management of valvular heart disease in Southern Africa
title_short	The implications of HIV infection on the management of valvular heart disease in Southern Africa
title_full	The implications of HIV infection on the management of valvular heart disease in Southern Africa
title_fullStr	The implications of HIV infection on the management of valvular heart disease in Southern Africa
title_full_unstemmed	The implications of HIV infection on the management of valvular heart disease in Southern Africa
title_sort	implications of hiv infection on the management of valvular heart disease in southern africa
publisher	South African Heart Association
publishDate	2017
url	https://doaj.org/article/673ea6001460487586d905376e2972b4
work_keys_str_mv	AT dpnaidoo theimplicationsofhivinfectiononthemanagementofvalvularheartdiseaseinsouthernafrica AT kshein theimplicationsofhivinfectiononthemanagementofvalvularheartdiseaseinsouthernafrica AT dpnaidoo implicationsofhivinfectiononthemanagementofvalvularheartdiseaseinsouthernafrica AT kshein implicationsofhivinfectiononthemanagementofvalvularheartdiseaseinsouthernafrica
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The implications of HIV infection on the management of valvular heart disease in Southern Africa

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