title: Prevalence and predictors of long corrected QT interval in HIV-positive patients: a multicenter study.
abstract: OBJECTIVE
  HIV and highly active antiretroviral therapy (HAART) may affect cardiac conduction, and a higher incidence of sudden death has been recognized in HIV-positive patients. Nevertheless, predictors of prolonged corrected QT interval (cQT) have been poorly described. The aim of the study was to investigate the prevalence and predictors of long cQT in a cohort of HIV-positive patients.
  
  
  METHODS
  Consecutive HIV-positive patients followed in a primary prevention clinic at two Italian institutions were retrospectively enrolled. A 12-lead ECG was recorded in all patients; main clinical features were collected. Prevalence of long cQT (defined as cQT >470 ms in women and >450 ms in men) was the primary end-point. Secondary end-points were the identification of predictors of cQT prolongation, and the association between HAART and HIV-related features with long cQT.
  
  
  RESULTS
  Three hundred and fifty-one HIV-positive patients were included, 26 (7.4%) with long cQT. Mean age was higher among those with long cQT (51.6 vs. 57.6 years; P = 0.007). A higher prevalence of long cQT was reported for patients with a CD4+ cell count below 200 cells/μl at the moment of ECG (60 vs. 24.2%; P = 0.002) and with a nadir of CD4+ cell count below 200 cells/μl (91.3 vs. 58.6%; P = 0.001). At multivariate analysis, only the nadir of CD4+ cell count below 200 cells/μl consistently related to the presence of long cQT (odds ratio 5.8, 95% confidence interval 1.3-26.4).
  
  
  CONCLUSIONS
  A low CD4+ cell count is associated with long cQT independently from HAART in HIV-positive patients and may be useful to correctly stratify arrhythmic risk in these patients.
authors.affiliation: aDivision of Cardiology, Department of Medical Sciences, Città Della Salute e della Scienza Hospital, University of Turin, Turin bDepartment of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Policlinico "Umberto" I, Rome, Italy cDepartment of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Policlinico 'Umberto I', Rome dDivision of Infectious Disease, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Gili
authors.forename: Massimo
authors.initials: M
authors.lastname: Mancone
authors.forename: Flavia
authors.initials: F
authors.lastname: Ballocca
authors.forename: Walter
authors.initials: W
authors.lastname: Grosso Marra
authors.forename: Andrea
authors.initials: A
authors.lastname: Calcagno
authors.forename: Gabriella
authors.initials: G
authors.lastname: D'Ettorre
authors.forename: Margherita
authors.initials: M
authors.lastname: Cannillo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Orofino
authors.forename: Laura
authors.initials: L
authors.lastname: Marruncheddu
authors.forename: Enrica
authors.initials: E
authors.lastname: Lonni
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cinque
authors.forename: Francesco
authors.initials: F
authors.lastname: Vullo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ceccarelli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Vilardi
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Vullo
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonora
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors