title: Prevalence and factors associated with a prolonged QTc interval in a cohort of asymptomatic HIV-infected patients.
abstract: We aimed to determine the prevalence of a prolonged QTc interval in HIV-infected patients and its related factors through an observational study of a cohort of asymptomatic HIV-infected outpatients. All patients underwent a standard 12-lead electrocardiogram and a transthoracic echocardiogram. Prolonged QTc was considered if it was >440 ms in men and >450 ms in women. Epidemiological, clinical, and laboratory data were collected and the patients completed a questionnaire about cardiovascular risk factors. The analysis of the potential risk factors for prolonged QTc was done by multivariate logistic regression. The study included 194 patients, 84% men, with a mean age of 46.3 years. The mean duration of HIV infection was 122.6 months and 27.8% had AIDS. Antiretroviral therapy was being taken by 185 (96.4%) patients, and 92.4% of them had an undetectable viral load. The mean CD4 lymphocyte count was 553/mm(3). A total of 24 (12.4%) patients had a prolonged QTc interval, with a mean QTc of 456 ms. The factors associated with a prolonged QTc were hyperlipidemia (OR 3.7, 95% CI: 1.3-10.3; p=0.01) and diastolic dysfunction (OR 6.7, 95% CI: 2.4-18.3; p=0.0001), while the use of atazanavir was associated with a lower likelihood of having a prolonged QTc (OR 0.11, 95% CI: 0.02-0.5; p=0.008). A prolonged QTc syndrome was not uncommon in this cohort of asymptomatic HIV-infected patients with good immunovirological control. It was associated with hyperlipidemia and diastolic dysfunction. The use of atazanavir, compared with other protease inhibitors, was associated with a lower likelihood of having a prolonged QTc.
authors: UGC de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
authors: Tamara
authors: T
authors: Moreno
authors: Isabel
authors: I
authors: Pérez
authors: Guillermo
authors: G
authors: Isasti
authors: Fernando
authors: F
authors: Cabrera
authors: Jesús
authors: J
authors: Santos
authors: Rosario
authors: R
authors: Palacios
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D000069446:Atazanavir Sulfate; D018791:CD4 Lymphocyte Count; D004562:Electrocardiography; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006339:Heart Rate; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D008133:Long QT Syndrome / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use; D015995:Prevalence; D011725:Pyridines / Q000627:therapeutic use; D012307:Risk Factors; D011795:Surveys and Questionnaires; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate