The prevalence of coronary heart disease in human immunodeficiency virus positive individuals in Harare, Zimbabwe

Abstract

Coronary heart disease is complex with several well established as well as postulated risk factors and pathogenetic mechanisms. This public health problem is a major cause of morbidity and mortality in the industrialised world. HIV is now well recognised as a risk factor for coronary and ischaemic heart disease in the industrialised world but has been hitherto not studied in the black African population. In this study a case control autopsy series of HIV-positive and negative deceased black Zimbabweans was done with the objective of estimating the coronary heart disease rates in these individuals and establishing an association, if any, between HIV-infection and CHD. CHD was present with prevalence rates of 18.1% and 9.5% in HIV-positive and negative individuals respectively, although these prevalence rates were not as high as those in industrialised countries where CHD has reached epidemic proportions. There was however no statistically significant association between HIV infection and CHD. It has therefore become necessary for clinicians treating HIV-positive black African patients to actively investigate for and manage coronary heart disease and its risk factors. There is potential to reduce previously unrecognised morbidity and mortality in HIV. In addition coronary heart disease is now prevalent in the general black Zimbabwean population and may be a source of clinically apparent disease.