Impact of highly active antiretroviral therapy in HIV-positive patients with cardiac involvement.

Cardiac involvement is frequently observed in HIV-infected patients, especially in those in the late stage of the disease. This study was designed to evaluate the impact of highly active antiretroviral therapy (HAART) in patients with cardiac involvement. A retrospective study of 1042 patients admitted to a Division of Infectious Diseases between 1989 and 1998. During the period 1989-1995, 544 patients were treated with nucleoside reverse transcriptase inhibitors (NRTI), whereas 498 patients were treated with HAART during the period 1996-1998. Cardiac involvement, including arrhythmias, pericarditis, ischaemia, dilated cardiomyopathy, endocarditis, pulmonary hypertension, and myocarditis were observed in 282 of 544 (51.8%) patients treated with NRTI, compared with 93 of 498 (18.6%) patients with HAART (P < 0.0001). HAART has significantly decreased the incidence of cardiac involvement, especially pericarditis, arrhythmias, and dilated cardiomyopathy.