Human Immunodeficiency Virus-Associated Myocardial Diastolic Dysfunction and Soluble ST2 Concentration in Tanzanian Adults: A Cross-Sectional Study

Justin R. Kingery, Parag Goyal, Rahul Hosalli, Myung Hee Lee, Bernard Desderius, Fredrick Kalokola, Abel Makubi, Salama Fadhil, Saidi Kapiga, Dipan Karmali, Daniel Kaminstein, Richard Devereux, Margaret Mcnairy, Warren Johnson, Daniel Fitzgerald, Robert Peck

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aims of this study were (1) to compare the prevalence of myocardial diastolic dysfunction (DD) in antiretroviral therapy (ART)-naive people living with human immunodeficiency virus (PLWH) to human immunodeficiency virus (HIV)-uninfected adults in East Africa and (2) to determine the association between serum concentration of the cardiac biomarkers ST2 and DD. Methods: In this cross-sectional study, we enrolled PLWH and uninfected adults at a referral HIV clinic in Mwanza, Tanzania. Standardized history, echocardiography, and serum were obtained. Regression models were used to quantify associations. Results: We enrolled 388 ART-naive PLWH and 461 HIV-uninfected adults with an average age of 36.0 ± 10.2 years. Of PLWH in the third, fourth, and fifth decades of life, 5.0%, 12.5%, and 32.7%, respectively, had DD. PLWH had a higher prevalence of DD (adjusted odds ratio, 2.71 [95% confidence interval, 1.62-4.55]; P < .0001). PLWH also had a higher probability of dysfunction with one or fewer traditional risk factors present. Serum ST2 concentration was associated with dysfunction in PLWH but not uninfected participants (P = .04 and P = .90, respectively). Conclusions: In a large population of young adults in sub-Saharan Africa, DD prevalence increased starting in the third decade of life. HIV was independently associated with dysfunction. Serum ST2 concentration was associated with DD in PLWH but not HIV-uninfected participants. This pathway may provide insight into the mechanisms of HIV-associated dysfunction.

Original languageEnglish (US)
Pages (from-to)83-93
Number of pages11
JournalJournal of Infectious Diseases
Volume223
Issue number1
DOIs
StatePublished - Jan 1 2021

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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