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 cardiovascularabnormalities has generated much interest. This study aimed atdetermining the prevalence of QTc prolongation among HIVpatients and determining the influence if any of the use of HAARTon the QTc and on the risk of having QTc prolongation.MATERIALS AND METHODS: One hundred and fifty HIVpositive subjects comprising 76 HIV positive subjects on HAART(Group A), 74 who were HAART- naïve (Group B), and 150 ageand sex-matched healthy controls (Group C) were studied. Allsubjects had electrocardiography, and QTc duration wascalculated.RESULTS: Mean QTc was significantly different among the threegroups (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 wassignificantly longer among patients with CD4 count <200cells/mm 3 than among those with >200 cells/mm 3 0.445 + 0.03secsvs 0.421 + 0.03secs (P<0.001). QTc prolongation was commoneramong individuals with CD4 count <200 cells/mm 3 50% vs 20.5%(P<0.001). On binary logistic regression, none of the HAARTmedications used by our patients was predictive of the occurrenceof QTc prolongation.CONCLUSION: The QTc is longer, and QTc prolongation occursmore frequently in HAART-naïve HIV patients than patients onHAART and healthy controls. None of the HAART medicationsused by our patients was predictive of the development of QTcprolongation.