Background: Left ventricular hypertrophy (LVH) is an early marker of cardiac involvement and a predictor of heart failure and mortality. This study aimed to determine the incidence of LVH, describe its progression trajectory after initiation of antiretroviral therapy (ART), and identify risk factors for LVH among people living with HIV (PLHIV). Methods: This retrospective cohort study included 154 adults living with HIV who were followed at the University Clinics of Kinshasa between 2000 and 2003 and had been on ART for at least six months. Clinical, laboratory, and electrocardiographic data were analyzed to assess the incidence, progression, and risk factors of LVH. Results: The overall prevalence of LVH was 29.2%. Survival analysis showed that patients on TDF 3TC EFV had a higher risk of developing LVH compared to those on TDF 3TC LPV/r (adjusted hazard ratio [aHR] = 3.39; p = 0.003). Hypertension (aHR = 3.79; p = 0.001) and proteinuria (aHR = 2.97; p = 0.026) were identified as independent risk factors, while CD4 count was not significantly associated after adjustment. Conclusion: These findings confirm the importance of hypertension and renal impairment in left ventricular remodeling and suggest a potential role of ART regimen choice in cardiovascular health.
Cite this paper
Lupenzi, B. M. , Nkodila, A. N. , Kintoki, E. V. , Kasiam, J. B. and Longo-Mbenza, B. (2026). Incidence and Evolutionary Trajectory of Left Ventricular Hypertrophy in People Living with HIV in the DRC: A Retrospective Cohort. Open Access Library Journal, 13, e15248. doi: http://dx.doi.org/10.4236/oalib.1115248.
Guwatudde, D., Nankya-Mutyoba, J., Kalyesubula, R., Laurence, C., Adebamowo, C., Ajayi, I., et al. (2015) The Burden of Hypertension in Sub-Saharan Africa: A Four-Country Cross Sectional Study. BMC Public Health, 15, Article No. 1211. https://doi.org/10.1186/s12889-015-2546-z
Roth, G.A., Mensah, G.A., Johnson, C.O., Addolorato, G., Ammirati, E., Baddour, L.M., et al. (2020) Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019. Journal of the American College of Cardiology, 76, 2982-3021. https://doi.org/10.1016/j.jacc.2020.11.010
Benjamin, I.J., FAHA, FACC, et al. (2021) 2020 American Heart Association and American College of Cardiology Consensus Conference on Professionalism and Ethics: A Consensus Conference Report. Circulation, 143, e1035-e1087. https://doi.org/10.1161/CIR.0000000000000963
Kamdar, F., Das, S., Gong, W.M., et al. (2020) Stem Cell-Derived Cardiomyocytes and Beta-Adrenergic Receptor Blockade in Duchenne Muscular Dystrophy Cardiomyopathy. Journal of the American College of Cardiology, 75, 1159-1174. https://doi.org/10.1016/j.jacc.2019.12.066
Hoffman, R.M., Chibwana, F., Banda, B.A., Kahn, D., Gama, K., Boas, Z.P., et al. (2022) High Rate of Left Ventricular Hypertrophy on Screening Echocardiography among Adults Living with HIV in Malawi. Open Heart, 9, e002026.https://doi.org/10.1136/openhrt-2022-002026
Okelloa, S., Amira, A., Bloomfielde, G.S., Kentoffio, K., Lugobeg, H.M., Reynolds, Z., et al. (2020) Prevention of Cardiovascular Disease among People Living with HIV in Sub-Saharan Africa. Progress in Cardiovascular Diseases, 63, 149-159.https://doi.org/10.1016/j.pcad.2020.02.004
Bezati, S., Velliou, M., Ventoulis, I., Simitsis, P., Parissis, J. and Polyzogopoulou, E. (2023) Infection as an Under-Recognized Precipitant of Acute Heart Failure: Prognostic and Therapeutic Implications. Heart Failure Reviews, 28, 893-904.https://doi.org/10.1007/s10741-023-10303-8
Shah, A.S.V., Stelzle, D., Lee, K.K., Beck, E.J., Alam, S., Clifford, S., et al. (2021) Global Burden of Atherosclerotic Cardiovascular Disease in People Living with HIV: A Systematic Review and Meta-Analysis. Circulation, 138, 1100-1112. =1379988 https://doi.org/10.1161/CIRCULATIONAHA.117.033369
Șoldea, S., Iovănescu, M., Berceanu, M., Mirea, O., Raicea, V., Beznă, M.C., et al. (2025) Cardiovascular Disease in HIV Patients: A Comprehensive Review of Current Knowledge and Clinical Implications. International Journal of Molecular Sciences, 26, Article 1837. https://doi.org/10.3390/ijms26051837
Nagueh, S.F., Smiseth, O.A., Appleton, C.P., Byrd, B.F., et al. (2016) Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography, 29, 277-314. https://doi.org/10.1016/j.echo.2016.01.011
World Health Organization (2021) Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a public Health Approach. https://www.who.int/publications/i/item/9789240031593
Feinstein, M.J., Hsue, P.Y., Benjamin, L.A., et al. (2019) Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV: A Scientific Statement from the American Heart Association. Circulation, 140, e98-e124. https://doi.org/10.1161/CIR.0000000000000695
Kruzliak, P., Syamasundar, R.P., Novak, M., et al. (2013) Unilateral Absence of Pulmonary Artery: Pathophysiology, Symptoms, Diagnosis and Current Treatment. Archives of Cardiovascular Diseases, 106, 448-454. https://doi.org/10.1016/j.acvd.2013.05.004
