Ogunmola Olarinde Jeffrey, Oladosu Yusuf O, Olamoyegun Michael A
Department of Internal Medicine, Cardiac Care Centre, Federal Medical Centre, Ido Ekiti, Ekiti State, Nigeria.
Ann Afr Med. 2015 Oct-Dec;14(4):169-76. doi: 10.4103/1596-3519.152072.
QTc interval prolongation signifies an increased risk of life-threatening arrhythmia and sudden cardiac death. Cardiac manifestations of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome have become increasingly important causes of morbidity and mortality. We investigated HIV-positive patients to determine the effects of HIV infection, antiretroviral drugs, and identifiable confounders on QTc prolongation.
A case-control study was conducted in a rural tertiary health center in Nigeria. Data collected included demographic variables, body mass index, blood pressure, HIV status, antiretroviral treatment (ART), duration of HIV infection and treatment, CD4 T-lymphocyte count, heart rate (HR), and QT interval. QT was corrected for HR using Bazett's formula.
The sample frame comprised 89 (42.4%) HIV-negative subjects (39.3% male, 60.7% female; mean age, 36.28 ± 7.03 years); 45 (21.4%) HIV-positive, ART-naïve patients (31.1% male, 68.9% female; mean age, 36.48 ± 9.12 years); and 76 (36.2%) HIV-positive patients on ART (27.6% male, 72.4% female; mean age, 39.00 ± 7.68 years). The QTc interval and resting HR were higher in HIV-positive, drug-naïve patients than in the other two groups (P < 0.001). Female sex was associated with prolonged QTc intervals in all groups.
HIV-positive patients may be at higher risk of sudden cardiac death due to fatal arrhythmia secondary to QTc interval-related cardiac events. Healthcare providers should be aware that a prolonged QTc interval is a potential indicator of increased cardiovascular risk and should exercise caution in prescribing potentially QT-prolonging medications to HIV-positive patients.
QTc间期延长表明发生危及生命的心律失常和心源性猝死的风险增加。人类免疫缺陷病毒（HIV）和获得性免疫缺陷综合征的心脏表现已成为发病率和死亡率日益重要的原因。我们对HIV阳性患者进行了调查，以确定HIV感染、抗逆转录病毒药物和可识别的混杂因素对QTc延长的影响。
在尼日利亚的一家农村三级医疗中心进行了一项病例对照研究。收集的数据包括人口统计学变量、体重指数、血压、HIV状态、抗逆转录病毒治疗（ART）、HIV感染和治疗持续时间、CD4 T淋巴细胞计数、心率（HR）和QT间期。使用Bazett公式对QT进行心率校正。
样本框架包括89名（42.4%）HIV阴性受试者（男性39.3%，女性60.7%；平均年龄36.28±7.03岁）；45名（21.4%）未接受抗逆转录病毒治疗的HIV阳性患者（男性31.1%，女性68.9%；平均年龄36.48±9.12岁）；以及76名（36.2%）接受抗逆转录病毒治疗的HIV阳性患者（男性27.6%，女性72.4%；平均年龄39.00±7.68岁）。未接受抗逆转录病毒治疗的HIV阳性患者的QTc间期和静息心率高于其他两组（P<0.001）。在所有组中，女性与QTc间期延长有关。
HIV阳性患者可能因QTc间期相关心脏事件继发的致命心律失常而发生心源性猝死的风险更高。医疗保健提供者应意识到QTc间期延长是心血管风险增加的潜在指标，在为HIV阳性患者开具有潜在QT延长作用的药物时应谨慎。
