Abstract
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.
| Original language | English (US) |
|---|---|
| Journal | Journal of the International Association of Providers of AIDS Care |
| Volume | 18 |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- antiretroviral therapy
- ECG
- HIV
- methadone
- QT prolongation
- QTc
ASJC Scopus subject areas
- Immunology
- Dermatology
- Infectious Diseases
Cite this
Prolonged QTc in HIV-Infected Patients : A Need for Routine ECG Screening. / Myerson, Merle; Kaplan-Lewis, Emma; Poltavskiy, Eduard; Ferris, David; Bang, Heejung.
In: Journal of the International Association of Providers of AIDS Care, Vol. 18, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prolonged QTc in HIV-Infected Patients
T2 - A Need for Routine ECG Screening
AU - Myerson, Merle
AU - Kaplan-Lewis, Emma
AU - Poltavskiy, Eduard
AU - Ferris, David
AU - Bang, Heejung
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - antiretroviral therapy
KW - ECG
KW - HIV
KW - methadone
KW - QT prolongation
KW - QTc
UR - http://www.scopus.com/inward/record.url?scp=85063712429&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063712429&partnerID=8YFLogxK
U2 - 10.1177/2325958219833926
DO - 10.1177/2325958219833926
M3 - Article
C2 - 30907255
AN - SCOPUS:85063712429
VL - 18
JO - Journal of the International Association of Providers of AIDS Care
JF - Journal of the International Association of Providers of AIDS Care
SN - 2325-9574
ER -