The use of first line Highly Active Anti-Retroviral Therapy (HAART) is not associated with QTC prolongation in HIV patients

Abstract

Background HAART has improved survival of HIV patients. Its contribution to the development of new cardiovascular abnormalities has generated much interest. This study aimed at determining the prevalence of QTc prolongation among HIV patients and determining the influence if any of the use of HAART on the QTc and on the risk of having QTc prolongation. Materials and Methods One hundred and fifty HIV positive subjects comprising 76 HIV positive subjects on HAART (Group A), 74 who were HAART- naïve (Group B), and 150 age and sex-matched healthy controls (Group C) were studied. All subjects had electrocardiography, and QTc duration was calculated. Results Mean QTc was significantly different among the three groups (P <0.001), highest in Group B > Group A > Group C. Frequency of QTc prolongation was highest in Group B (32%)>, Group A (17.3%)> Group C (4.7%) (P<0.001). Mean QTc was significantly longer among patients with CD4 count <200 cells/mm 3 than among those with >200 cells/mm 3 0.445 ± 0.03secs vs 0.421 ± 0.03secs (P<0.001). QTc prolongation was commoner among individuals with CD4 count <200 cells/mm 3 50% vs 20.5% (P<0.001). On binary logistic regression, none of the HAART medications used by our patients was predictive of the occurrence of QTc prolongation. Conclusion The QTc is longer, and QTc prolongation occurs more frequently in HAART-naïve HIV patients than patients on HAART and healthy controls. None of the HAART medications used by our patients was predictive of the development of QTc prolongation.

Association between exposure to Efavirenz and substrates of dysrhythmia in HIV‐infected young adults

“…There is controversy about the impact of Efavirenz on QT length regardless of its subsequent clinical manifestations. 9,[16][17][18][19] Nevertheless, most studies such as the one by Charbit et al, found that prolonged QT is associated with conventional factors as well as chronicity of HIV infection rather than with ART drugs. 20 We found that Efavirenz regimen increased the length of corrected QT interval overall and in males while females were not affected.…”

Sudden cardiac death in HIV‐infected patients: A contemporary review

“…Numerous studies have reported an increased prevalence of QT prolongation among HIV‐infected individuals compared to uninfected controls possibly due to concurrent administration of QT‐prolonging medications as well as the effect of the virus itself on the QTc interval 9‐12 . Table 1 summarizes six studies which compared the prevalence of QTc prolongation between HIV‐infected individuals vs. an uninfected control group 9,10,13‐16 . QT prolongation is a precursor for life‐threatening arrhythmias including torsades de pointes.…”