Prevalence and risk factors of prolonged QTc interval in HIV-infected patients: results of the HIV-HEART study.
BACKGROUND
Corrected QT (QTc) prolongation is predictive of cardiovascular mortality in both the general and human immunodeficiency virus (HIV) populations.


OBJECTIVE
As part of the HIV-HEART study, we assessed the prevalence and risk factors of a prolonged QTc interval in patients with HIV infection.


METHODS
In this cross-sectional cohort study, 802 unselected HIV-infected patients were included. Data were analyzed by the use of gender-specific QTc categories (men abnormal at > 440 ms and women abnormal at >460 ms). Multiple variables related to infection and treatment were collected. Results were analyzed with a multivariable model.


RESULTS
The QTc interval was found to be prolonged in 154 patients (19.8%; 95% CI 17-23). The mean (+/-SD) QTc in men (n = 142) presenting with a prolonged QTc interval was 456 +/- 16.3 ms (range 441-548 ms). The mean (+/-SD) QTc in women (n = 12) presenting with a prolonged QTc interval was 479 +/- 9 ms (range 465-498 ms). In the multivariable model, female gender, diabetes mellitus, and arterial hypertension were associated with prolonged QTc. There were no parameters related to HIV independently associated with QT interval prolongation. In particular, no anti-HIV drug was associated with QTc prolongation.


CONCLUSIONS
Our study demonstrated that in an HIV-infected population, QTc prolongation had a high prevalence of nearly 20% compared to the general population and was possibly influenced by common factors like gender, diabetes, and arterial hypertension.
Reinsch
Nico
N
West-German Heart Center, Department of Cardiology, University of Essen, Essen, Germany. nico.reinsch@uk-essen.de
Buhr
Christiane
C
Krings
Peter
P
Kaelsch
Hagen
H
Neuhaus
Kathrin
K
Wieneke
Heiner
H
Erbel
Raimund
R
Neumann
Till
T
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006678:HIV / Q000254:growth & development*; D015658:HIV Infections / Q000503:physiopathology* / Q000821:virology; D006801:Humans; D008133:Long QT Syndrome / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence