Abstract
OBJECTIVES: Persons living with HIV (PLWH) face double the risk of cardiovascular disease (CVD) compared to others. We assessed HIV prevalence among patients presenting to a Tanzanian emergency department (ED) with acute myocardial infarction (AMI) or heart failure (HF). METHODS: In this prospective observational study (Nov 2020-Jan 2023), adults with chest pain or dyspnea were enrolled. Patients without known HIV underwent HIV 1/2 assay and confirmatory testing. AMI was defined per the Fourth Universal Definition; HF by physician diagnosis at discharge. Thirty-day follow-up was via phone or home visit. RESULTS: Of 836 enrolled participants, 344 (41.1%) met criteria for AMI or HF. Among these, 16 (4.7%) had HIV (15 known, 1 new). In participants without AMI or HF, 17 (3.5%) had known HIV. Follow-up was achieved for 99.8% (n = 834). HIV-positive participants with AMI or HF had higher unadjusted 30-day mortality than HIV-negative participants (37.5% vs 24.5%, OR 1.93, 95% CI: 1.05-3.60, p < 0.05). CONCLUSIONS: Targeted HIV testing for patients with cardiovascular complaints in a Tanzanian ED setting may not be a high-yield method for identifying new HIV cases. Future studies should be tailored to populations underrepresented in current programs. Thirty-day mortality following AMI or HF diagnosis is significantly higher for PLWH in Tanzania, emphasizing the need for interventions to address poor clinical outcomes of CVD among this population.