Cardiac Abnormalities among HIV-Exposed Infants in North-Central Nigeria: Implications for Early Echocardiographic Screening — A Cross-Sectional Comparative Study

Background : With the success of prevention of mother-to-child transmission programmes, the number of HIV-exposed but uninfected (HEU) infants in sub-Saharan Africa continues to increase. Emerging evidence suggests that in-utero exposure to HIV and antiretroviral therapy may influence cardiovascular development. However, data on cardiac abnormalities among HIV-exposed infants in Nigeria remain limited. Methods : A cross-sectional comparative study was conducted among 312 infants (156 HIV-exposed and 156 HIV-unexposed) attending the Federal Medical Centre, Bida, Nigeria. Infants aged 0–52 weeks were recruited. Transthoracic echocardiography was used to assess cardiac structure and function. Echocardiographic parameters were compared between groups, and statistical significance was set at p < 0.05. Results : Cardiac abnormalities were significantly more common among HIV-exposed infants compared with HIV-unexposed infants (66.7% vs 2.6%, p < 0.001). The abnormalities were predominantly structural and included increased interventricular septal thickness and left ventricular posterior wall thickness. HIV-exposed infants also demonstrated higher fractional shortening and ejection fraction, indicating increased myocardial contractility. Infant age was the only factor significantly associated with cardiac abnormalities among HIV-exposed infants (p = 0.032) Conclusion : Cardiac abnormalities were common among HIV-exposed infants in this setting and were largely subclinical. These findings highlight the potential value of echocardiographic evaluation in the early assessment of HIV-exposed infants.