ElectroCardioGraphic QTc Interval Prolongation in Aging THAI HIV infected Population After Receiving AntiRetroviral Therapy: ECG THAI-HAART Study

Abstract

Background: the QTc interval prolongation is commonly found in HIV infected patients with some controversial data showed the association between ART and this condition. To date, there is no data of the QTc interval prolongation in the aging HIV infected patients with the usage of current HAART regimens.

Method: we collected the data of the aging, 50 years old or more, ART-experience HIV infected patients in the HIV Netherland Australia Thailand research collaboration (HIV-NAT) who had digital ECG recorded to find the prevalence as a primary objective. The secondary objective is to find the associating factors of the QTc interval prolongation by using case-control study with age and sex propensity score matching between the patients with and without QTc interval prolongation in 1:2 ratio. The QTc interval prolongation was defined as QTc interval > 450 ms in man and > 460 ms in woman.

Result: 413 patients with the mean age of 56.0 (50-76) years old and 249 (60.3%) male patients were included from January 2019 to November 2019. There was no patient with AIDS and most of the patients were well disease control, mean CD4 level was 640.46 +/- 242.98 cells/mcl and 401 (97.1%) patients were undetectable viral load. The prevalence of the QTc interval prolongation was 22.3% (92/413). The older age, hypertension and Nevirapine use were found to associated with QTc interval prolongation in the unmatched analysis but found no association after matching. Univariable analysis of the matched case-control found the association of Tenofovir alafenamide and Atazanavir use with the QTc interval prolongation but no factor was found to be associated in multivariable analysis.

Conclusion: the prevalence of the QTc interval prolongation was higher in aging ART-experience HIV infected patient. Except the older age, there was no other factor including ART use found to associated with the QTc interval prolongation.