Prolonged QTc in HIV-Infected Patients: A Need for Routine ECG Screening.
Adult
Analgesics, Opioid
/ therapeutic use
Anti-Retroviral Agents
/ therapeutic use
Arrhythmias, Cardiac
/ etiology
Cross-Sectional Studies
Electrocardiography
Female
HIV Infections
/ complications
Humans
Long QT Syndrome
/ diagnosis
Male
Methadone
/ therapeutic use
Middle Aged
Prevalence
Risk Factors
ECG
HIV
QT prolongation
QTc
antiretroviral therapy
methadone
Journal
Journal of the International Association of Providers of AIDS Care
ISSN: 2325-9582
Titre abrégé: J Int Assoc Provid AIDS Care
Pays: United States
ID NLM: 101603896
Informations de publication
Date de publication:
Historique:
entrez:
26
3
2019
pubmed:
26
3
2019
medline:
27
6
2020
Statut:
ppublish
Résumé
With HIV-infected patients living longer, there is an increased burden of comorbidities related to aging, HIV itself, and polypharmacy. Cardiac morbidity is of particular importance. This 2-group comparison study (156 HIV-positive and 105 HIV-negative patients) investigated the prevalence of abnormalities in and factors associated with an electrocardiogram (ECG) measure, corrected QT interval (QTc), where prolongation can lead to arrhythmia and sudden death. Medications prescribed (antiretroviral therapy, psychiatric medications, methadone, and antibiotics) at the time of ECG were noted. Patient characteristics, medications, QTc, and ECG characteristics were compared between the 2 groups. Prolongation (29% versus 19%) and extreme prolongation (6% versus 1%) in QTc were more frequent in those with HIV. Antiretroviral therapy was associated with lower odds of prolonged QTc (odds ratio [OR] = 0.35; P = .04), while methadone with higher odds (OR = 4.6; P = .01) in HIV-positive patients. With methadone and medication groups adjusted, HIV status was still associated with 17-millisecond longer QTc ( P = .04). This study provides evidence that patients with HIV may have clinically relevant longer QTc interval on ECG. Baseline and routine ECG monitoring may be warranted among patients living with HIV in clinical practice based on cumulative evidence.
Sections du résumé
BACKGROUND
With HIV-infected patients living longer, there is an increased burden of comorbidities related to aging, HIV itself, and polypharmacy. Cardiac morbidity is of particular importance.
METHODS
This 2-group comparison study (156 HIV-positive and 105 HIV-negative patients) investigated the prevalence of abnormalities in and factors associated with an electrocardiogram (ECG) measure, corrected QT interval (QTc), where prolongation can lead to arrhythmia and sudden death. Medications prescribed (antiretroviral therapy, psychiatric medications, methadone, and antibiotics) at the time of ECG were noted. Patient characteristics, medications, QTc, and ECG characteristics were compared between the 2 groups.
RESULTS
Prolongation (29% versus 19%) and extreme prolongation (6% versus 1%) in QTc were more frequent in those with HIV. Antiretroviral therapy was associated with lower odds of prolonged QTc (odds ratio [OR] = 0.35; P = .04), while methadone with higher odds (OR = 4.6; P = .01) in HIV-positive patients. With methadone and medication groups adjusted, HIV status was still associated with 17-millisecond longer QTc ( P = .04).
CONCLUSION
This study provides evidence that patients with HIV may have clinically relevant longer QTc interval on ECG. Baseline and routine ECG monitoring may be warranted among patients living with HIV in clinical practice based on cumulative evidence.
Identifiants
pubmed: 30907255
doi: 10.1177/2325958219833926
pmc: PMC6435291
mid: NIHMS1016970
doi:
Substances chimiques
Analgesics, Opioid
0
Anti-Retroviral Agents
0
Methadone
UC6VBE7V1Z
Types de publication
Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2325958219833926Subventions
Organisme : NIAID NIH HHS
ID : R01 AI131998
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001860
Pays : United States
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