School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, ZA; Centre for the Study of Emerging and Re-emerging Infections (CREMER), Institute for Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation
Dipolelo Mokaila
Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town; Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town
Olukayode Aremu
Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town; Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town
Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town; Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7501, Cape Town, ZA; Centre for Tropical Diseases and Global Health, Catholic University of Bukavu
Jonathan Blackburn
Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town; Department of Integrative Biomedical Sciences, University of Cape Town
Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7501, Cape Town, ZA; World Health Organization Regional Office for Africa, Cité du Djoué, Brazzaville
Ntobeko Ntusi
Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town; Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town; Cape Universities Body Imaging Centre, Faculty of Health Sciences, University of Cape Town, Cape Town
Socioeconomic factors such as poor health and poor nutrition in low- and middle-income countries (LMICs) may favour inflammatory reactions, thus contributing to the recurrence of rheumatic fever (RF) and thereby modifying trends in rheumatic heart disease (RHD). Apart from epidemiological studies, studies of HIV infections in RHD patients are limited. This systematic review synthesises data on the prevalence and impact of HIV infections or AIDS on RHD from PubMed, Scopus, Web of Science databases up to April 2021. The outcomes were managed using PRISMA guidelines. Of a total of 15 studies found, 10 were eligible for meta-analyses. Meta-analysis found that 17% (95 % CI 8–33, I2 = 91%) of adults in cardiovascular disease (CVD) cohorts in Southern Africa are HIV positive. The proportion of RHD diagnosed among people living with HIV was 4% (95% CI 2–8, I2 = 79%) for adults but lower [2% (95% CI 1–4, I2 = 87%)] among perinatally infected children. Despite limited reporting, HIV-infected patients with RHD are prone to other infections that may enhance cardiac complications due to poor immunological control. PROSPERO registration number: CRD42021237046.
