Congestive Heart Failure in HIV-infected Patients - Project description
Background
Infection with the HIV virus affects not only the human immune system; organ systems, including the cardiovascular system, are also repeatedly affected. The introduction of new therapeutic concepts for the treatment of HIV infection in recent years made it possible to improve the immunological situation of the majority of HIV-positive patients on a sustained basis. Despite a lack of knowledge of long-term effects, the new treatments are widely used in the western industrialized countries.
However, the range of side effects of anti-retroviral therapy is expected to result in an increase in heart disease. It is not clear whether diseases such as dilated cardiomyopathy will play a lifetime-limiting role in this patient group in the coming years. Up to now, there has not been any reliable data available in Germany or internationally on HIV-associated cardiomyopathy and its causes.
Objective
The goal of the subproject „Congestive Heart Failure in HIV-infected Patients“ is the recording of the incidence of dilated cardiomyopathy in patients infected with HIV, taking into account gender, the stage of HIV infection and anti-retroviral therapy.
In addition to the incidence of HIV-associated cardiomyopathy, the present research project will collect information about the pathological mechanisms and the course of the disease. From these data, evidence for the incidence and prognosis of HIV-associated cardiomyopathy can be derived which can contribute to early detection and development of preventive measures.
Implementation
A network consisting of specialist cardiology departments, hospital wards and private practices with a focus on HIV.
The prerequisites for answering questions about the topic of heart disease in patients infected with HIV were created only by the close collaboration of the project participants with the Heart Failure Competence Network and the previously established HIV & AIDS Competence Network.
With the assistance of the network, more than 800 HIV-positive persons were tested for cardiovascular disease in the past two years. The follow-up examinations will take place in the second support phase and currently include over 95% of the target sample size. In addition to information about HIV infection and pre-existing illnesses, the physical stamina and cardiac function of the HIV-positive persons was recorded using a 6-minute walking test and transthoracic echocardiography. Moreover, the status of the HIV infection, blood parameters (CD4 cells, viral load) and anti-retroviral therapy are included in the analysis. The HIV-positive patients will be monitored for three years to record the progress of the dilated cardiomyopathy.
Added value via networking
The objectives of the research project are the comprehensive analysis and exploration of HIV-associated dilated cardiomyopathy. Due to the limited number of HIV-positive people with cardiovascular disease in each individual center and the heterogeneity of the illnesses, data collection that was adequate for performing representative analyses of the type, severity, etiology and progression was made possible only via the network.