A comparison of HIV-positive patients with and without infective endocarditis: An echocardiographic study - The Emory endocarditis group experience

Dustin T. Smith, Matthew Sherwood, Ryan Crisel, James Abraham, Craig Mansour, Emir Veledar, Robert Mondschein, Stamatios Lerakis

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objective. To determine the clinical features in HIV-positive patients with and without infective endocarditis (IE). Patients and Methods: All bacteremic, HIV-positive patients with suspected IE admitted over a four-year period who underwent either transesophageal echocardiography (TEE) or transthoracic echocardiography (TTE) were retrospectively reviewed with regard to clinical, laboratory, and demographic characteristics. Results: Ten (11.5%) of 87 HIV-positive patients had a clinical diagnosis of IE based on the Duke Criteria. The mean age of patients with IE was 37.8 years and without IE 39.9 years (P = NS). Both patient groups were similar with respect to gender, race, IVDA, renal failure requiring hemodialysis, history of predisposing heart disease, origin of infection, and causative organism of infection. The mean CD4 count (cells/μL) was 200.7 in patients with IE and 95.9 in patients without IE (P = NS). Of 10 HIV-positive patients with IE, seven had left-sided heart involvement, two had complications related to IE, three required cardiothoracic surgery, and three died. Conclusions: There were no differences found with regard to the clinical characteristics of HIV-positive patients with and without IE. No correlation could be drawn between mortality and the degree of immunosuppression in patients from this study. The high incidence of IE (11.5%) and mortality rate (30%) in this study suggests that IE in HIV-positive patients, including non-intravenous drug abusers, represents a real concern for clinicians and their management of these patients.

Original languageEnglish
Pages (from-to)145-149
Number of pages5
JournalAmerican Journal of the Medical Sciences
Volume328
Issue number3
DOIs
StatePublished - Sep 2004
Externally publishedYes

Keywords

  • AIDS
  • Bacteremia
  • Echocardiography
  • Endocarditis
  • HIV

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