Division of Cardiovascular Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital.
Division of Ambulatory and Hospital Medicine, Department of Medicine, Faculty of Medicine.
AIDS. 2022 Dec 1;36(15):2153-2159. doi: 10.1097/QAD.0000000000003358. Epub 2022 Aug 12.
To assess the prevalence, and factors associated with QTc interval prolongation, among 383 virologically suppressed people with HIV (PWH), without evidence of cardiovascular disease and active opportunistic infections in Thailand.
Cross-sectional study.
Resting 12-lead digital ECGs were performed in 2019. QT interval corrected for heart rate (QTc) >450 ms in males and >460 ms in females was defined as QTc interval prolongation. We used multivariable logistic regression to investigate factors associated with QTc interval prolongation.
Mean (standard deviation) age was 56 (5.5) years and 42% were female. The median current CD4+ was 619 (interquartile range [IQR] 487, 769) cells/mm 3 . The median duration of antiretroviral therapy (ART) was 11.9 (IQR 7.1-16.1) years. Commonly used ART were rilpivirine (37.9%), efavirenz (20.1%), atazanavir/ritonavir (15.7%), lopinavir/ritonavir (12.3%) and dolutegravir (5%). The prevalence of QTc interval prolongation was 22.7%. In multivariable analysis, older age (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.02-1.12, P = 0.005), female sex (OR 1.69, 95% CI 1.01-2.82, P = 0.046) and increasing BMI (OR 1.08, 95% CI 1.01-1.15, P = 0.03) were associated with QTc interval prolongation. With every 1-year increase in age, the odds of QTc interval prolongation increased by 7%.
In this well-suppressed aging Asian HIV cohort, the prevalence of QTc interval prolongation was relatively high, and associated with increasing age, female sex, and higher BMI. For PLWH with these characteristics, QTc interval should be monitored before and after initiating any medications known to prolong QTc intervals, to prevent fatal cardiac arrhythmias.
评估 383 名无心血管疾病和活动性机会性感染证据且病毒学抑制的艾滋病毒感染者（PLWH）中 QTc 间期延长的发生率，以及相关因素。该研究在泰国进行。
横断面研究。
2019 年进行了静息 12 导联数字心电图检查。男性 QTc 间期校正心率（QTc）＞450ms 和女性 QTc 间期校正心率（QTc）＞460ms 定义为 QTc 间期延长。我们采用多变量逻辑回归分析与 QTc 间期延长相关的因素。
平均（标准差）年龄为 56（5.5）岁，42%为女性。目前中位 CD4+细胞计数为 619（四分位距 [IQR]487，769）细胞/mm3。中位抗逆转录病毒治疗（ART）时间为 11.9（IQR7.1-16.1）年。常用的 ART 包括利匹韦林（37.9%）、依非韦伦（20.1%）、阿扎那韦/利托那韦（15.7%）、洛匹那韦/利托那韦（12.3%）和多替拉韦（5%）。QTc 间期延长的患病率为 22.7%。多变量分析显示，年龄较大（比值比 [OR]1.07，95%置信区间 [CI]1.02-1.12，P=0.005）、女性（OR 1.69，95%CI1.01-2.82，P=0.046）和 BMI 增加（OR 1.08，95%CI1.01-1.15，P=0.03）与 QTc 间期延长相关。年龄每增加 1 岁，QTc 间期延长的可能性增加 7%。
在这个年龄较大且病毒学抑制良好的亚洲 HIV 队列中，QTc 间期延长的患病率相对较高，与年龄增长、女性和 BMI 增加相关。对于具有这些特征的 PLWH，在开始使用已知会延长 QTc 间期的任何药物之前和之后，都应监测 QTc 间期，以预防致命性心律失常。
