Subclinical myocardial disease by cardiac magnetic resonance imaging and spectroscopy in healthy HIV/Hepatitis C virus-coinfected persons

J Int Med Res. 2017 Dec;45(6):1693-1707. doi: 10.1177/0300060517708919. Epub 2017 Jun 12.

Abstract

Objective The contribution of hepatitis C virus (HCV) infection to the risk of heart failure in human immunodeficiency virus (HIV)-coinfected persons is unknown. The objective was to characterize cardiac function and morphology in HIV-treated coinfected persons. Methods In a cross-sectional study, HIV-infected patients virologically suppressed on antiretroviral therapy without known cardiovascular disease or diabetes mellitus underwent cardiac magnetic resonance imaging and spectroscopy for measures of cardiac function, myocardial fibrosis, and steatosis. Results The study included 18 male patients with a median age of 44 years. Of these, 10 had untreated HCV coinfection and eight had HIV monoinfection. Global systolic and diastolic function in the cohort were normal, and median myocardial fat content was 0.48% (interquartile range 0.35-1.54). Left ventricular (LV) mass index and LV mass/volume ratio were significantly greater in the HIV/HCV-coinfected group compared with the HIV-monoinfected group. In the HIV-monoinfected group, there was more myocardial fibrosis as measured by extracellular volume fraction. Conclusions There were differences between HIV/HCV-coinfected and HIV-monoinfected patients in cardiac structure and morphology. Larger studies are needed to examine whether HIV and HCV independently contribute to mechanisms of heart failure.

Keywords: HIV; cardiac magnetic resonance imaging; heart disease; hepatitis C; magnetic resonance spectroscopy; myocardial fibrosis; myocardial steatosis.

MeSH terms

  • Adult
  • Coinfection / diagnosis*
  • Coinfection / virology*
  • HIV Infections / diagnosis*
  • Hepacivirus / physiology*
  • Hepatitis C, Chronic / diagnosis*
  • Humans
  • Linear Models
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Myocardium / pathology*
  • Proton Magnetic Resonance Spectroscopy
  • Spectrum Analysis*