HIV Infection Is Associated with Longer Electrocardiographic QTc Intervals: Baseline Evaluation from the CHART Cohort

Background: Prolonged QT interval on electrocardiogram reflects abnormalities in ventricular repolarization may contribute to the greater risk for sudden cardiac death among people living with HIV (PLWH). We investigated whether HIV infection is associated with corrected QT intervals. Methods: Data was derived from baseline assessment of Comparative HIV and Aging Research in Taizhou (CHART), China, 1452 PLWH and 3524 HIV-negative individuals were included. QT correction was performed with Bazett, Fridericia, Framingham and Hodges formulas. QT prolongation was defined as corrected QT interval ≥460 ms in females and ≥450 ms in males. Results: In multivariable models adjusting for traditional risk factors, there was a significantly 3.3 ms (95% confidence interval [CI] 1.7‒10.4) longer mean QTcBazett, 3.0 ms (1.5‒4.4) QTcFramingham, 3.7 ms (2.2‒5.2) QTcHodges and 3.4 ms (1.8‒4.9) QTcFridericia in PLWH vs HIV-negative individuals. Bazett detected the highest prevalence of QTc prolongation in PLWH especially those with resting heart rate (RHR) >100 bpm and significant difference between two groups. Regardless of formula used, older age, female sex, lower LDL, hypertension, lower eGFR, ECG-left ventricular hypertrophy, longer duration since HIV diagnosis and higher HIV RNA were associated with longer QTc intervals among PLWH. Conclusions: HIV infection is independently associated with longer QTc intevals, such risk increases with the infection prolonged and at high HIV RNA. Bazett formula is not recommended for PLWH as they tend to have faster RHR. Additional longitudinal investigations into the prognostic values of QTc intervals in combination with other ECG parameters for incident CVD events are warranted among PLWH.