GW24-e3755 Acquired QTc prolongation in HIV-infected patients: the prevalence, risk factors, and clinical significance

Objectives

Recent study showed that corrected QT (QTc) prolongation is an independent risk factor for sudden cardiac death, which is predictive of cardiovascular mortality in human immunodeficiency virus (HIV) populations. To assess the prevalence and risk factors of QTc prolongation in patients with HIV infection and further address the clinical significance.

Methods

The electrocardiograms (EKG) of 108 consecutive HIV-infected adults (>18 years) from January to December 2012 were reviewed. Data were analysed by the use of gender-specific QTc categories (men abnormal at > 440 ms and women abnormal at >460 ms) based on previous publication. Multiple variables of socio-demographic characteristics, laboratory findings and treatment were collected. Framingham score was calculated to assess 10-year cardiovascular risk, and D:A:D score based on traditional cardiovascular risk factors as well as HIV-specific factors was calculated to assess 5-year cardiovascular risk.

Results

The QTc interval was found to be prolonged in 25% HIV-infected patients. The mean ( ± SD) QTc was 474 ± 34ms in QTc prolongation group (range 442-551 ms in men and 473-486 in women), whereas 418 ± 23ms in normal QTc group (range 411-439 ms in men and 413-459 ms in women). The HIV-infected patients with prolonged QTc interval have higher D:A:D score (4.3 ± 4.7 vs 2.0 ± 2.9) and Framingham score (12.3 ± 13.4 vs 6.0 ± 7.3) than those with normal QTc interval. However, there were no clinical or latoratory parameters related to HIV independently associated with QTc 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 25% compared to the general population. Though no single parameter or medication was related to QTc prolongation, the overall likelihood of developing cardiovascular disease and its relevant risk factors might contribute to prolonged QTc interval.